TUFTS--FIELDING

第5节.资源核心1： 功能评估核心(FAC) 尽管美国老年人的慢性残疾患病率仍在下降， 65岁以上患有慢性残疾的总人数正在增加(1，2)。目前， 行动不便影响到近四分之一的65岁以上的人和四分之三的居住在 养老院(3)。在非残疾老年人中，在爬楼梯等任务中行动不便， 在房间里行走被定义为“行动不便”(4)。捕获和评估移动性 老年人的局限性，已经开发出功能能力的性能测试，并已显示 预测意外伤残、住院和死亡率(4，5)。尤其是单单行走能力， 根据4米步行测试中的步态速度测量，已被证明是随后的 日常生活能力障碍和行动障碍(6)。此外，经过验证的高度可靠的工具可用于评估 身体残疾的组成部分也已在观察性研究中开发和实施 临床试验。最近，在选定的动物模型(大鼠、小鼠)中的测试方案已被开发为 评估与这些物种的损伤和功能限制相关的重要终点。 身体功能评估核心寻求提供必要的基础设施来执行标准化， 在一系列临床研究中，有效和可靠地测量身体损伤、功能和残疾 支持Tuft-BU OIAC或与之关联。此外，该相同的核心将为 通过一系列基础(动物模型)研究评估身体损伤和功能 并得到塔夫茨-BU OAIC的支持或附属于该组织。这一核心的领导层进行了广泛的合作 在过去的十年中，在这些测量方法的广泛应用方面有丰富的经验 在老年人中进行的一系列横断面和干预研究，并在 动物模型中肌肉损伤和功能的评估。这一独特的跨学科结构 CORE将提供一个论坛，用于执行这些经过验证的标准化评估，并进一步细化和 扩展新技术的可用性，以评估各种物理功能和功能容量 从啮齿动物到人类的物种。 1.为中心调查人员在开发过程中进行跨学科协作提供焦点； 评估和应用新的和现有的工具和工具来评估肌肉损伤， 老年人的功能限制、残疾和功能促进疗法。 2.促进和促进开发和完善评估肌肉的工具和仪器 衰老动物模型中的表现和身体功能。 3.标准化肌肉性能和功能评估的设备和操作规程 人类和动物研究的局限性。实施和维护以下人员的培训和认证 应用标准化的肌肉性能和功能限制测试方案。 建立和维护设备校准，以便在所有中心研究中使用。 广泛的基础研究和临床试验将受益于这一核心的集体资源。 越来越多地，由于来自监管机构的压力和评估更远的结果的明确需要， 在老年人中进行的功能促进疗法的试验，肌肉损失(骨质疏松症)的治疗 旨在通过评估主观症状(例如：疲劳、精力、困难)来评估治疗效果 在日常生活活动中)和身体机能的客观测量(例如：步态速度、椅子站立 载客量、爬楼梯性能)。此外，针对特定疾病的新的治疗干预措施 有功能障碍的老年人的病理生理变化和损害必须继续 检查过了。最后，对实验室啮齿动物进行基因改造的能力的出现增加了对 为了充分评估这些动物在身体损伤方面的表型，如自愿 肌肉力量和功能限制，如步态、玉米表现和平衡。关键人员 隶属于FAC的机构是唯一有资格为这一核心提供必要支持和基础设施的机构。

SECTION 5. RESOURCE CORE 1: FUNCTIONAL ASSESSMENT CORE (FAC) Although the prevalence of chronic disability in older individuals remains on the decline in the United States, the total number of individuals over the age of 65 with chronic disability is increasing (1, 2). Presently, limitations in mobility affect almost one in four individuals over age 65 and three quarters of those living in nursing homes (3). In non-disabled older individuals, limitations in mobility in such tasks as climbing stairs, and walking across a room have been defined as "mobility disability" (4). To capture and assess mobility limitations in the elderly, performance tests of functional capacity have been developed and have been shown to be predictive of incident disability, institutionalization, and mortality (4, 5). In particular, walking ability alone, as measured by gait speed during a 4 M walk test, has been shown to be a strong predictor of subsequent ADL disability and mobility disability (6). In addition, validated highly reliable instruments to assess components of physical disability have also been developed and implemented in observational studies and clinical trials. More recently, testing protocols in selected animal models (rats, mice) have been developed to assess important endpoints related to impairments and functional limitations in these species. The physical function assessment core seeks to provide the necessary infrastructure to perform standardized, valid and reliable measures physical impairments, function, and disability across the array of clinical studies supported or associated with the Tufts-BU OIAC. In addition, this same core will provide support for the assessment of physical impairments and function across an array of basic (animal model) studies associated and supported by or affiliated with the Tufts-BU OAIC. The leadership of this core has collaborated extensively over the past ten years, has extensive experience in the application of these measurements across a wide range of cross-sectional and intervention studies in older adults, and is uniquely cross-trained in the assessment of muscle impairments and functioning in animal models. This uniquely structured interdisciplinary core will provide a forum for performing these validated standardized assessments and to further refine and expand the availability of new techniques to assess physical functioning and functional capacity across a range of species from rodents to humans. 1. Provide a focal point for interdisciplinary collaboration by Center investigators in the development, evaluation, and application of new and existing tools and instruments to assess muscle impairments, functional limitations, and disability in older adults and function promoting therapies. 2. Promote and foster the development and refinement of tools and instruments to assess muscle performance and physical functioning in animal models of aging. 3. Standardize equipment and operating protocols for the assessment of muscle performance & functional limitations in human and animal studies. Implement and maintain personnel training and certification for the application of standardized muscle performance and functional limitations testing protocols. Establish and maintain equipment calibration for use across all Center studies. A wide array of basic studies and clinical trials would benefit from the collective resources of this core. Increasingly, due to pressure from regulatory agencies and a defined need to assess more distal outcomes in trials of function promoting therapies in older adults, treatments of muscle loss (sarcopenia) have been directed to assess therapeutic efficacy by assessing subjective symptomatology (eg: fatigue, energy, difficulty in activities of daily living) and objective measures of physical functioning (eg: gait velocity, chair stand capacity, stair climbing performance). In addition, novel therapeutic interventions targeted at specific pathophysiological changes and impairments in older individuals with functional limitations must continue to be examined. Finally the emergence of the ability to genetically modify laboratory rodents has increased the need to adequately assess the phenotype of these animals with respect to physical impairments such as voluntary muscle strength and functional limitations such as gait, maize performance and balance. The key personnel affiliated with the FAC are uniquely qualified to provide the necessary support and infrastructure for this core.