Centre for Musculoskeletal Ageing Research

衰老是一个复杂的过程，会导致人体大多数器官系统的功能降低，肌肉骨骼系统(肌肉、骨骼、肌腱和软骨)受到严重影响。肌肉骨骼系统不仅会随着年龄的增长而丧失肌肉、骨骼和软骨，还会因为神经系统功能的下降而受到损害，这会导致对运动和平衡的控制能力降低。衰老还经常伴随着体重增加，这会对关节造成进一步的压力，并导致软骨和骨骼的侵蚀，增加发展为骨关节炎(OA)的机会。重要的是，衰老和肥胖都会降低体力活动水平，增加体内炎症水平，改变荷尔蒙平衡，所有这些都会影响身体维持肌肉骨骼系统的能力。因此，增加体力活动和能够减少炎症和纠正年龄和肥胖相关激素变化的干预措施，为延缓肌肉骨骼系统与年龄相关的变化提供了一条前进的道路。目标：目标是通过整合和扩大伯明翰和诺丁汉两所主要米德兰大学的互补研究和研究生培训活动，以及它们相关的NHS医院信托基金，建立一个肌肉骨骼老化研究卓越中心。该中心还将建立一个独特的技术设施来测量人类的肌肉、肌腱和骨骼代谢，这将为英国研究界提供宝贵的资源。该中心的总体研究目的是了解衰老是如何导致肌肉骨骼功能丧失的，并利用这一知识来干预和尽量减少与年龄相关的肌肉骨骼衰退和疾病。这些干预措施的主要重点将是锻炼和饮食。临床益处：该中心开展的这项研究的潜在临床益处是显著的，因为与年龄相关的肌肉骨骼功能丧失会产生重大的临床后果，包括增加跌倒和骨折(髋关节和手腕)、骨关节炎和疼痛的风险。每年每3名老年人中就有1人摔倒，对于76,000名患者来说，这会导致髋部骨折。髋部骨折与发病率增加、丧失独立性有关，髋部骨折的一年死亡率为22%。英国有600万人患有骨性关节炎，这是一种痛苦的疾病，降低了工作能力，并对生活质量产生了重大影响。肥胖会加剧骨性关节炎，目前除了疼痛治疗外，没有其他治疗方法。研究问题：1.驱动肌肉骨骼系统组成组织老化的关键因素是什么，无论是单独的还是作为一个综合系统？这将包括遗传和生活方式的作用；炎症、体力活动和组织类固醇激素变化的作用；与年龄相关的神经肌肉功能丧失及其对协调、平衡和执行复杂运动任务(如驾驶)能力降低的影响。2.改善老年肌肉骨骼功能的干预措施评估。众所周知，随着年龄的增长，体育锻炼可以减少肌肉和骨量的损失。在年轻受试者中，膳食补充剂可以增加肌肉质量，改善新陈代谢，减少炎症，但对老年人的疗效在很大程度上尚不清楚。该中心将确定对健康和虚弱的老年人进行肌肉骨骼维护的最佳运动和营养补充方案。干预措施还将包括旨在减少炎症和调整荷尔蒙平衡以有利于肌肉骨骼维护的药理学方法。3.确定老年人增加体力活动或减肥的心理和环境(实际)障碍将是该中心处理的一个关键问题，目的是制定对老年人实用和有吸引力的干预措施。

Ageing is a complex process that results in the reduced functioning of most of the body's organ systems, with the musculoskeletal system (muscle, bone, tendon and cartilage) significantly affected. The musculoskeletal system is compromised not only by loss of muscle, bone and cartilage with age, but also by the decline in function of the nervous system which results in reduced control of movement and balance. Ageing is also often accompanied by weight gain which puts further strain on joints and contributes to erosion of cartilage and bone, increasing the chances of developing Osteoarthritis (OA). Importantly both ageing and obesity decrease physical activity levels and increase the level of inflammation in the body and alter hormone balance, all of which affect the ability of the body to maintain the musculoskeletal system. Therefore increased physical activity and interventions that are able to reduce inflammation and correct age and obesity related hormone changes, offer a way forward for delaying age-related changes in the musculoskeletal system. Objectives: The objective is to set up a Centre of Excellence in Musculoskeletal Ageing Research by integrating and expanding the complementary research and postgraduate training activity of the two leading Midlands based Universities, Birmingham and Nottingham, together with their associated NHS hospital trusts. The Centre will also establish a unique technical facility for measuring human muscle, tendon and bone metabolism that will provide a valuable resource for the UK research community. The Centre's over-arching research aim is to understand how ageing results in loss of musculoskeletal function and to use this knowledge to intervene and minimise age-related musculoskeletal decline and disease. The major focus of these interventions will be exercise and diet. Clinical benefits: The potential clinical benefits of the research carried out by the Centre are significant as age-related loss of musculoskeletal function has major clinical consequences, including increased risk of falls and fracture (hip and wrist), OA and pain. 1 in 3 older adults fall each year and for 76,000 patients this results in hip fracture. Hip fracture is associated with increased morbidity, loss of independence and the 1 year mortality figure for hip fracture is 22%. There are 6 million people with OA in the UK1, a painful condition which reduces the ability to work and has a significant impact upon quality of life. OA is exacerbated by obesity and there are currently no treatments other than pain remediation.Research questions: 1. What are the key factors driving ageing of the component tissues of the musculoskeletal system, both individually and as an integrated system? This will include the role of genetics and lifestyle; the role of inflammation, physical activity and changes in tissue steroid hormones; age-related loss of neuromuscular function and its contribution to reduced coordination, balance and reduced ability to perform complex motor tasks such as driving. 2. Assessment of interventions to improve musculoskeletal function in old age. It is well established that physical activity reduces the loss of muscle and bone mass with age. In young subjects dietary supplements can increase muscle mass, improve metabolism and reduce inflammation, but efficacy in older adults is largely unknown. The Centre will determine optimal exercise and nutritional supplementation regimes for musculoskeletal maintenance in older adults, both healthy and frail. Interventions will also include pharmacological approaches aimed at reducing inflammation and adjusting hormone balance in favour of musculoskeletal maintenance. 3. Identifying psychological and environmental (practical) barriers to increased physical activity or weight loss in older adults will be a key question addressed by the Centre, with the aim of developing interventions that will be practical and attractive to older adults.