Low Magnitude Mechanical Stimulation to Increase Muscle Strength in Frail Adults

描述（由申请人提供）：肌肉减少症，即与年龄相关的骨骼肌质量损失，导致活动能力受损、虚弱和残疾。然而，肌肉质量的损失和肌肉力量的损失之间存在不匹配，这表明肌肉质量随着年龄的增长而受损。脂肪渗入骨骼肌（肌脂肪变性）影响肌肉质量 并且可能与行动不便和残疾有关。肌肉数量和肌肉质量是脆弱发展的潜在早期可改变因素。本提案的目的是 在一项前瞻性队列研究中，对1，172名65岁及以上的社区居民男性进行检查，通过外周定量计算机断层扫描评估脂肪渗入骨骼肌是否独立和交互地预测肌肉力量、身体表现、虚弱、残疾和死亡的下降。此外，我们假设，改善肌肉质量和质量的干预措施将防止虚弱和残疾。因此，我们的第二个目的是研究一种低影响、非药物性的装置是否能为全身提供低强度的机械刺激，从而改善低功能成人的肌肉力量。该提案还将探讨低幅度机械是否会增加肌肉质量并减少肌间脂肪。受试者将从当地的辅助生活社区招募，这些社区为许多老年人提供聚集的住房和社交活动。我们假设，低幅度的机械刺激将有助于对抗肌肉减少症和脆弱的老年人谁是在不良后果的风险最高的独立性丧失。这个指导以患者为导向的职业发展奖的候选人旨在补充她以前在老年医学和流行病学方面的培训，并在肌肉生理学，身体成分成像方法和干预性临床研究方面提供额外的专业知识。哥伦比亚大学已投入大量资源支持这一提议，包括使用NIH CTSA资助的欧文研究所的生物标志物实验室。多学科指导团队由脆弱、身体成分、肌间脂肪和临床试验设计方面的专家组成 老年人支持这项建议。拟议的研究应该提供有关肌间脂肪在残疾发展中的重要性的新信息，并可能导致治疗和预防肌肉减少症的新策略。

DESCRIPTION (provided by applicant): Sarcopenia, the age-related loss of skeletal muscle mass, contributes to impaired mobility, frailty and disability. However, there is a mismatch between the loss in muscle mass and loss in muscle strength, suggesting that muscle quality is impaired with aging. Infiltration of fat into skeletal muscle (myosteatosis) affects muscle quality and may be related to impaired mobility and disability. Muscle quantity and muscle quality are potentially early modifiable factors in the development of frailty. The goal of this proposal is to examine whether infiltration of fat into skeletal muscle, assessed by peripheral quantitative computed tomography, independently and interactively predicts decline in muscle strength, physical performance, frailty, disability and death in a prospective cohort of 1,172 community dwelling men aged 65 years and older. Furthermore, we hypothesize that interventions that improve both muscle mass and quality will prevent weakness and disability. Thus, our second aim is to study whether a low-impact, nonpharmacologic device providing low magnitude mechanical stimulation to the whole body improves muscle strength in low functioning adults. This proposal will also explore whether low magnitude mechanical increases muscle mass and decrease intermuscular fat. Subjects will be recruited from local assisted living communities, which provide congregate housing and social events for many older adults. We hypothesize that low magnitude mechanical stimulation will help combat sarcopenia and loss of independence among frail older adults who are at the highest risk of adverse outcomes. The candidate for this mentored Patient-Oriented Career Development Award aims to complement her previous training in geriatrics and epidemiology with additional expertise in muscle physiology, body composition imaging methodology, and interventional clinical research. Columbia University has committed abundant resource to support this proposal including the use of bionutrition, biomarkers laboratory in the NIH CTSA-funded Irving Institute. A multidisciplinary mentorship team comprised of experts in frailty, body composition, intermuscular fat and clinical trial design in the elderly supports the proposal. The proposed studies should provide novel information about the importance of intermuscular fat in the development of disability, and could lead to new strategies for the treatment and prevention of sarcopenia.