Age-related decline in muscle mass and strength, termed sarcopenia, is a primary contributor to mobility problems, frailty, and institutionalization among older adults. Nearly half of all U.S. elders have low muscle mass or strength and the associated direct healthcare costs are estimated to exceed $18 billion per year. These numbers will only increase as the population of older adults continues to expand and live longer. Yet despite the major public health impact of sarcopenia there is no accepted clinical definition and no effective therapies that can be used to prevent or reverse sarcopenia.
Foot Disorders and Foot Biomechanics
Foot pain and certain foot disorders are very common in the general population, with disability related to these foot problems also a frequent occurrence in the community. Population-based studies indicate of the 25% of men and women with foot pain, approximately two-thirds report at least moderate disability. Foot disorders have been shown to have a detrimental impact on health-related quality of life across a spectrum of age-groups. Risk factors include increased age, being female, improperly fitting shoes, obesity and chronic medical conditions such as osteoarthritis and diabetes. Despite the high prevalence and significant impact of foot pain, and structural foot disorders, relatively little is known about the underlying risk factors for development.
Poor diet and nutritional deficiencies are associated with major causes of morbidity and mortality including, but not limited to osteoporosis, sarcopenia (age-related muscle loss), cardiovascular disease, hypertension, type 2 diabetes and some types of cancer. Osteoporosis and sarcopenia are major public health problems in the United States with direct medical costs of approximately $17 billion and $18.5 billion per year respectively. These diseases of the musculoskeletal system lead to falls, related fractures, disability, loss of independence and even death. Adequate nutrition is important in achieving and maintaining optimal bone mass as well as muscle health. Evaluating the relation of nutrition with bone and muscle health is of keen importance as it may lead to dietary recommendations that will help prevent these debilitating diseases. Nutrition has always played a central role in prevention and treatment for chronic diseases, and our work moves these ideas beyond the current boundaries. Below are the three proposed projects via which the Nutrition Program at the Institute for Aging Research aims to identify novel risk factors and pathways involved in age-related bone and muscle loss. This work has an overall theme of nutritional interventions at earlier phases of these diseases as well as increased detection of people at high risk of these diseases, with the overarching promise of strategies that will lead to prevention of disease and development of effective interventions across the life span for adults.
Osteoporosis, Fractures and Falls
Osteoporosis is considered a major public health threat for an estimated 44 million Americans, or half of those aged 50 and older. An estimated 10 million in the U.S. already have the disease. Women are at higher risk than men. Another 34 million Americans have low bone density, putting them at increased risk for osteoporosis and fractures, especially of the hip, spine and wrist. About one-quarter of those who suffer a hip fracture die within a year of the injury. Osteoporosis-related fractures were responsible for an estimated $19 billion in health care costs in 2005, with that figure expected to increase to $25 billion by 2025.
Spine Health in Older Adults
Excessive curvature of the spine, or hyperkyphosis, affects as many as 20-40% of older adults and poses serious problems in performing everyday activities like walking, standing, reaching, and even breathing. Despite the public health burden of hyperkyphosis, little is known about ways to prevent the occurrence of this common condition or to reduce risk of progression of forward spinal posture with aging. Identifying the causes and clinical impact of hyperkyphosis may help to develop methods to prevent the disability and disfigurement associated with poor spine health in older adults.
Systems Genetics, Bioinformatics and Geri-OMICS Research
Musculoskeletal disorders have been shown to have a detrimental impact on health-related quality of life across a spectrum of age-groups. Despite the high prevalence and significant impact of musculoskeletal disorders, relatively little is known about how genes work together with the environment to cause diseases of the musculoskeletal system. Common age-related conditions that are inherited, such as osteoporosis (bone loss), sarcopenia (loss of muscle), muscle weakness, foot disorders and metabolic syndrome (insulin-related obesity) result in disability and frailty. Since these conditions are genetically determined, knowledge about their molecular underpinnings may yield important discoveries related to prevention and treatment.