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Cesari M, Azzolino D, LeBrasseur NK, Whitson H, Rooks D, Sourdet S, Angioni D, Fielding RA, Vellas B, Rolland Y, Andrieu S, Leheudre MA, Barcons N, Beliën A, de Souto Barreto P, Delannoy C, John G, Robledo LMG, Hwee D, Mariani J, Reshma M, Morley J, Pereira S, Erin Q, Michelle R, Rueda R, Tarasenko L, Tourette C, Van Maanen R, Waters DL. Resilience: Biological Basis and Clinical Significance - A Perspective Report from the International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force. J Frailty Aging 2022; 11:342-347. [PMID: 36346720 PMCID: PMC9589704 DOI: 10.14283/jfa.2022.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Resilience is a construct receiving growing attention from the scientific community in geriatrics and gerontology. Older adults show extremely heterogeneous (and often unpredictable) responses to stressors. Such heterogeneity can (at least partly) be explained by differences in resilience (i.e., the capacity of the organism to cope with stressors). The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met in Boston (MA,USA) on April 20, 2022 to discuss the biological and clinical significance of resilience in older adults. The identification of persons with low resilience and the prompt intervention in this at-risk population may be critical to develop and implement preventive strategies against adverse events. Unfortunately, to date, it is still challenging to capture resilience, especially due to its dynamic nature encompassing biological, clinical, subjective, and socioeconomic factors. Opportunities to dynamically measure resilience were discussed during the ICFSR Task Force meeting, emphasizing potential biomarkers and areas of intervention. This article reports the results of the meeting and may serve to support future actions in the field.
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Affiliation(s)
- Matteo Cesari
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, University of Milan, Via Camaldoli 64, 20138 Milano, Italy
| | - D. Azzolino
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, University of Milan, Via Camaldoli 64, 20138 Milano, Italy
| | - N. K. LeBrasseur
- Robert and Arlene Kodod Center on Aging, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, USA
| | - H. Whitson
- Duke University School of Medicine & Durham VA Medical Center, Durham, USA
| | - D. Rooks
- Translational Medicine, Novartis Institutes for Biomedical Research Inc., Cambridge, USA
| | - S. Sourdet
- Gérontopôle de Toulouse, Centre Hospitalier-Universitaire de Toulouse, Inserm 1295, Université de Toulouse, Toulouse, France
| | - D. Angioni
- Gérontopôle de Toulouse, Centre Hospitalier-Universitaire de Toulouse, Inserm 1295, Université de Toulouse, Toulouse, France
| | - R. A. Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA, Human Nutrition Research Center on Aging at Tufts University, Boston, MA USA
| | - B. Vellas
- Gérontopôle de Toulouse, Centre Hospitalier-Universitaire de Toulouse, Inserm 1295, Université de Toulouse, Toulouse, France
| | - Y. Rolland
- Gérontopôle de Toulouse, Centre Hospitalier-Universitaire de Toulouse, Inserm 1295, Université de Toulouse, Toulouse, France
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Cesari M, Bernabei R, Vellas B, Fielding RA, Rooks D, Azzolino D, Mariani J, Oliva AA, Bhasin S, Rolland Y. Challenges in the Development of Drugs for Sarcopenia and Frailty - Report from the International Conference on Frailty and Sarcopenia Research (icfsr) Task Force. J Frailty Aging 2022; 11:135-142. [PMID: 35441189 PMCID: PMC9017069 DOI: 10.14283/jfa.2022.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Sarcopenia and frailty represent two burdensome conditions, contributing to a broad spectrum of adverse outcomes. The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met virtually in September 2021 to discuss the challenges in the development of drugs for sarcopenia and frailty. Lifestyle interventions are the current mainstay of treatment options in the prevention and management of both conditions. However, pharmacological agents are needed for people who do not respond to lifestyle modifications, for those who are unable to adhere, or for whom such interventions are inaccessible/unfeasible. Preliminary results of ongoing trials were presented and discussed. Several pharmacological candidates are currently under clinical evaluation with promising early results, but none have been approved for either frailty or sarcopenia. The COVID-19 pandemic has reshaped how clinical trials are conducted, in particular by enhancing the usefulness of remote technologies and assessments/interventions.
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Affiliation(s)
- M Cesari
- Prof. Matteo Cesari; Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri; Via Camaldoli 64, 20138 Milano, Italy; Twitter: @macesari; E-mail:
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Abstract
Sarcopenia, the associated loss of skeletal muscle mass and strength and impaired physical function seen with aging, is a growing, global public health challenge in need of accepted, proven treatments that address the needs of a broad range of older adults. While exercise, primarily resistance training, and increased dietary protein have been shown to delay and even reverse losses in muscle mass, strength and physical function seen with aging, proven treatments that are accessible globally, cost effective and sustainable by patients are needed. While no drug has yet demonstrated the substantial safety and clinical value needed to be the first pharmacological therapy registered for muscle wasting or sarcopenia, the field is active. Several approaches to treating the muscle loss and subsequent functional decline are being studied in a variety of patient populations across every continent. We provide a review of the leading programs and approaches and available findings from recent studies. In addition, we briefly discuss several related issues needed to facilitate the development of a safe and efficacious pharmacotherapeutic that could be used as part of a treatment plan for older men and women with sarcopenia.
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Affiliation(s)
- D Rooks
- Daniel Rooks, The Department of Musculoskeletal Translational Medicine at the Novartis Institutes for BioMedical Research, 220 Massachusetts Avenue, Cambridge, MA 02139, USA,
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Guralnik J, Rooks D, Webb T. A SMARTPHONE APP FOR THE SHORT PHYSICAL PERFORMANCE BATTERY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J.M. Guralnik
- University of Maryland School of Medicine, Chevy Chase, Maryland,
| | - D. Rooks
- Novartis Institutes of Biomedical Research, Cambridge, Massachusetts,
| | - T. Webb
- GE Healthcare - Lunar, Madison, Wisconsin
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Vellas B, Pahor M, Manini T, Rooks D, Guralnik JM, Morley J, Studenski S, Evans W, Asbrand C, Fariello R, Pereira S, Rolland Y, Abellan van Kan G, Cesari M, Chumlea WC, Fielding R. Designing pharmaceutical trials for sarcopenia in frail older adults: EU/US Task Force recommendations. J Nutr Health Aging 2013; 17:612-8. [PMID: 23933872 PMCID: PMC4077187 DOI: 10.1007/s12603-013-0362-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
An international task force of academic and industry leaders in sarcopenia research met on December 5, 2012 in Orlando, Florida to develop guidelines for designing and executing randomized clinical trials of sarcopenia treatments. The Task Force reviewed results from previous trials in related disease areas to extract lessons relevant to future sarcopenia trials, including practical issues regarding the design and conduct of trials in elderly populations, the definition of appropriate target populations, and the selection of screening tools, outcome measures, and biomarkers. They discussed regulatory issues, the challenges posed by trials of different types of interventions, and the need for standardization and harmonization. The Task Force concluded with recommendations for advancing the field toward better clinical trials.
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Affiliation(s)
- B Vellas
- University of Toulouse III, Toulouse, France
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Abellan van Kan G, Cderbaum JM, Cesari M, Dahinden P, Fariello RG, Fielding RA, Goodpaster BH, Hettwer S, Isaac M, Laurent D, Morley JE, Pahor M, Rooks D, Roubenoff R, Rutkove SB, Shaheen A, Vamvakas S, Vrijbloed JW, Vellas B. Sarcopenia: biomarkers and imaging (International Conference on Sarcopenia research). J Nutr Health Aging 2011; 15:834-46. [PMID: 22159770 DOI: 10.1007/s12603-011-0365-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- G Abellan van Kan
- Gerontopole Toulouse, Department of Geriatric Medicine, Toulouse University Hospital, INSERM 1027, Toulouse, France
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Abstract
BACKGROUND Understanding interrelationships among disablement concepts is critical to the design of future disability treatment and prevention interventions. METHODS This study uses cross-sectional data to examine the relationships among physiologic impairments, functional limitations, and disability in a moderately disabled sample of 207 community-dwelling older adults. RESULTS As hypothesized, the data revealed statistically significant curvilinear relationships of upper and lower extremity strength and balance with mobility in this older sample. Multivariate analyses further clarified the hypothesized causal mechanism among the disablement concepts by demonstrating that most of the association of muscle strength and balance with disability was through the intermediary role of mobility limitations. CONCLUSIONS The findings from this study highlight the value of clinical trials that focus on prevention or treatment of mobility limitations as a means of preventing disability; our findings underscore the need for future research that examines the effects of other variables believed to influence disablement in late life.
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Affiliation(s)
- A M Jette
- Sargent College of Health and Rehabilitation Sciences, Boston University, USA.
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Jette AM, Rooks D, Lachman M, Lin TH, Levenson C, Heislein D, Giorgetti MM, Harris BA. Home-based resistance training: predictors of participation and adherence. Gerontologist 1998; 38:412-21. [PMID: 9726128 DOI: 10.1093/geront/38.4.412] [Citation(s) in RCA: 132] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This study identified factors associated with exercise participation and adherence in a sample of 102 sedentary, functionally limited, community-dwelling adults aged 60 to 94 years who participated in a home-based resistance training program. Stepwise regression analyses revealed that baseline physical factors (i.e., higher levels of mobility, weaker muscle strength, and fewer numbers of new medical conditions) were associated with higher rates of participation in the home program. Positive attitudes and a sense of control toward exercise, lower levels of confusion and depressive moods, and the development of fewer new medical problems during the program were related to higher levels of adherence to the program. Findings revealed that although physical health variables were the primary indicators of an older person's overall participation in the program, it was the psychological factors that were most important to adherence to this home-based program.
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Affiliation(s)
- A M Jette
- Sargent College of Health and Rehabilitation Sciences, Boston, University, MA 02215, USA.
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