Leader: Patrizia Rovere-Querini (UNISR); Other collaborator(s): Licia Iacoviello (NEUROMED), Maria Benedetta Donati (NEUROMED)
Sarcopenia often leads to loss of independence and poor quality of life. Early identification, adequate diagnosis, follow-up and, possibly, mitigation of sarcopenia, will improve the management of elderly people. Aims: 1) to monitor sarcopenia by coupling body composition data to functional assessments and neuromuscular changes (high-density surface electromyography); 2) to improve sarcopenia and frailty by small-molecule epigenetic inhibitors. Data collected from an existing cohort of volunteers will be compared with those obtained in experimental ageing (spoke 2) and with subjects included in the EPIC study (spoke 10). A pilot feasibility study treating volunteers with the identified inhibitor(s) will be eventually set up.
Brief description of the activities and of the intermediate results
Main policy/industry/practice implications: Beginning of the training activities with the healthcare professionals of the House of Health (Casa della salute) “Le Piagge” and the dissemination activities with people living in this quarter.
We continue to perform multidimensional geriatric evaluations (including blood sample collection and biobanking) in a large cohort of geriatric and neurologic patients. We have now completed 222 visits of participants previously enrolled in the FRASNET study and 51 patients affected by cognitive impairment.
After identifying the most appropriate methodology for determining frailty through a literature review and a comparison among the participating Operating Units (UO) of the Spoke, we measured the frailty index within the Moli-sani study. The Moli-sani study is a large population cohort that includes 24,325 individuals over the age of 35 (5,831 subjects over the age of 65), residing in the Molise region and randomly recruited from municipal registers between 2005 and 2010 through multistage sampling. For this purpose, biometric and clinical data (electrocardiogram, spirometry tests, anthropometric measurements, and blood pressure), lifestyle factors (dietary habits, physical activity, smoking habits, socioeconomic status), and psycho-emotional variables (stress, depression, resilience) were analyzed through standardized procedures, along with samples (citrate plasma, EDTA plasma, serum, cell pellets, DNA, and urine stored in a liquid nitrogen biobank). For defining outcomes (survival status, mortality, cause-specific hospitalization, incidence of neurodegenerative diseases), we updated the study's follow-up to 2020 using hospital discharge records, pharmaceutical records, and regional mortality registries. To construct the frailty index, we used 36 variables including clinical predictors and biomarkers measured in the samples stored in the biobank.
We have completed the dosage (though the Ella method) of the biomarkers selected in the context of WP3 (GDF15, sRAGE, FGF21 and Nfl) in 288 individuals.
The article “Frailty Index, Frailty Phenotype and 6-year mortality trends in the FRASNET Cohort” is under review at Frontiers in Geriatric Medicine.
The revision on “Impact of epigenetic and mitochondrial alterations on frailty and related outcomes in adults’ population: a systematic review with meta-analysis” is ongoing.
The Frailty index obtained in the Moli-sani cohort has been used as a predictor of mortality and hospitalizations both in the general population (n= 23340) and in the subgroup aged over 65 (n=4700). A manuscript is in preparation.
A complementary method to evaluate frailty has been tested in the Moli-sani cohort in collaboration with the Mario Negri Research Institute, by using a hierarchical cluster analysis in 9570 subjects older than 50 years. Multivariable logistic regression was then used to analyse the association between clusters and outcomes (total and cause-specific mortality and hospitalizations). Moreover, life style determinants of frailty have been analysed. A manuscript is in preparation.
We continue to perform multidimensional geriatric evaluations (including blood sample collection and biobanking) in a large cohort of geriatric and neurologic patients.
The article “MUSCLE HEALTH & AGEING” is under review at Frontiers in Ageing.
The revision on “Impact of epigenetic and mitochondrial alterations on frailty and related outcomes in adults’ population: a systematic review with meta-analysis” is ongoing.
The abstract “Early recognition and prompt treatment of acute sarcopenia: impact on short- and long-term outcomes” was accepted as poster presenatation at at the 15th International Conference on Frailty and Sarcopenia Research (ICFSR).
The abstract “Biomarkers for sarcopenia: predicting muscle mass and function decline through GDF-15, FGF21, sRAGE, and Neurofilaments” was accepted as oral presenattion at the 15th International Conference on Frailty and Sarcopenia Research (ICFSR).