About our Research
Our research takes a life course approach to understanding ageing and long-term conditions including sarcopenia, frailty and multi-morbidity. It embraces a broad spectrum of research, from mechanistic investigation to epidemiological studies and trials, with a key focus on translation – using our discovery science to inform advances in prevention, diagnosis and treatment.
We have successfully embedded mechanistic research in our epidemiological studies, having previously shown that collection of muscle biopsies is both feasible and acceptable to older study participants. In a collaboration with the Wellcome Centre for Mitochondrial Research, we assessed mitochondrial respiratory chain function (using phosphorous magnetic resonance spectroscopy in the calf muscles following exercise), mitochondrial respiratory chain content (measuring levels of subunits of complex I and IV in muscle biopsies), muscle morphology (biopsies) and physical health (grip strength, Timed Up-and-Go) in a group of healthy 85-year-olds. The participants had high levels of physical function and engaged regularly in aerobic physical activity. We found that the protocol, that included exercise of the calf muscles, was well tolerated. In this well-functioning group of older men and women we showed, for the first time, that mitochondrial respiratory chain function and content were preserved.
A participant’s exponential recovery curve for phosphocreatine following exercise
Dodds et al. Experimental Gerontology 2018;11380-85
Muscle Ageing Sarcopenia Study_Lifecourse (MASS_Lifecourse)
Although sarcopenia is more common among older people, and is often seen as an age-related condition, it is also found in younger adults and is known to be influenced by risk factors operating across the life course. Understanding early determinants of losses of muscle mass and function is therefore key to developing new approaches to prevention, diagnosis and treatment of sarcopenia.
Working with members of the public and patients we have designed a new study: Muscle Ageing Sarcopenia Study (MASS_Lifecourse). We are currently recruiting adults across a wide age range to take part, in which we characterise health and lifestyle in detail and measure body composition and physical function. We aim to gain insights into muscle health that will define the optimal timing and design of future interventions to prevent and treat sarcopenia.
MIlk Intervention Muscle Ageing (MIlkMAN)
Exercise and nutrition are known influences on muscle health and function, so that interventions to increase exercise and nutrient intake should be effective strategies to prevent or treat sarcopenia for at-risk individuals. However, to date, trial evidence has been inconsistent. Combining dietary supplementation with resistance exercise training may be the most effective approach to promote muscle health, but research is needed to define the type of dietary change. To date, trials have focused on nutrient supplementation – few studies have examined the impact of greater consumption of whole foods, which would increase intakes of groups of nutrients and non-nutrients at the same time, which could be beneficial.
We carried out the MIlkMAN study, a pilot intervention, designed to assess the feasibility and acceptability of combining milk consumption, a source of high-quality proteins, minerals and vitamins, with resistance exercise training, as an effective whole food-based intervention to improve muscle health and physical performance in older people. All participants took part in exercise training over a period of 6 weeks, but were randomized to one of three arms (two milk groups, one control). The pilot study was successfully completed in 2019.
Granic A, et al. BMJ Open. 2019 Oct 8;9(10):e031048. doi: 10.1136/bmjopen-2019-031048.
The K-SWAY trial
Vitamin K is thought to be involved in both bone health and maintenance of neuromuscular function. In a recent trial, the effect of vitamin K2 supplementation was tested on postural sway, falls, healthcare costs, and indices of physical function in older people at risk of falls. The study recruited 95 community-dwelling participants aged 65 and older who had had at least two falls, or one injurious fall, in the previous year; they were randomized to receive a daily oral supplement (200 μg or 400 μg) of vitamin K2, or placebo, for 1 year. There was no significant effect of either vitamin K2 dose on the primary outcome of anteroposterior sway and adjusted falls rates were similar in each group. No significant treatment effects were seen for other measures of sway or secondary outcomes, but costs were higher in both vitamin K2 arms than in the placebo arm. Oral vitamin K2 supplementation did not improve postural sway or physical function in older people at risk of falls.
Witham M et al. J Am Geriatr Soc 2019. doi: 10.1111/jgs.16024. [Epub ahead of print]
The LACE trial
The Leucine and ACE inhibitors for sarcopenia (LACE) trial is a multicentre randomised controlled trial funded by the NIHR Efficacy and Mechanisms Evaluation programme. Due to report in 2020, the trial has recruited older people with sarcopenia from 10 UK centres, testing perindopril (a heart medication) and leucine (an amino acid supplement) as ways to improve muscle size and strength over a one year period. Led by Miles Witham (Professor of Trials for Older People), the trial is run in partnership with the University of Dundee, University of Aberdeen, Imperial College London, and the Tayside Clinical Trials Unit. More information at www.lacetrial.org.uk