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Perazza LR, Brown-Borg HM, Thompson LV. Physiological Systems in Promoting Frailty. Compr Physiol 2022; 12:3575-3620. [PMID: 35578945 DOI: 10.1002/cphy.c210034] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Frailty is a complex syndrome affecting a growing sector of the global population as medical developments have advanced human mortality rates across the world. Our current understanding of frailty is derived from studies conducted in the laboratory as well as the clinic, which have generated largely phenotypic information. Far fewer studies have uncovered biological underpinnings driving the onset and progression of frailty, but the stage is set to advance the field with preclinical and clinical assessment tools, multiomics approaches together with physiological and biochemical methodologies. In this article, we provide comprehensive coverage of topics regarding frailty assessment, preclinical models, interventions, and challenges as well as clinical frameworks and prevalence. We also identify central biological mechanisms that may be at play including mitochondrial dysfunction, epigenetic alterations, and oxidative stress that in turn, affect metabolism, stress responses, and endocrine and neuromuscular systems. We review the role of metabolic syndrome, insulin resistance and visceral obesity, focusing on glucose homeostasis, adenosine monophosphate-activated protein kinase (AMPK), mammalian target of rapamycin (mTOR), and nicotinamide adenine dinucleotide (NAD+ ) as critical players influencing the age-related loss of health. We further focus on how immunometabolic dysfunction associates with oxidative stress in promoting sarcopenia, a key contributor to slowness, weakness, and fatigue. We explore the biological mechanisms involved in stem cell exhaustion that affect regeneration and may contribute to the frailty-associated decline in resilience and adaptation to stress. Together, an overview of the interplay of aging biology with genetic, lifestyle, and environmental factors that contribute to frailty, as well as potential therapeutic targets to lower risk and slow the progression of ongoing disease is covered. © 2022 American Physiological Society. Compr Physiol 12:1-46, 2022.
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Affiliation(s)
- Laís R Perazza
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
| | - Holly M Brown-Borg
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - LaDora V Thompson
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
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Effects of Three Months of Detraining on the Health Profile of Older Women after a Multicomponent Exercise Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203881. [PMID: 31614946 PMCID: PMC6843996 DOI: 10.3390/ijerph16203881] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 11/17/2022]
Abstract
Physical exercise results in very important benefits including preventing disease and promoting the quality of life of older individuals. Common interruptions and training cessation are associated with the loss of total health profile, and specifically cardiorespiratory fitness. Would detraining (DT) promote different effects in the cardiorespiratory and health profiles of trained and sedentary older women? Forty-seven older women were divided into an experimental group (EG) and a control group (CG) (EG: n = 28, 70.3 ± 2.3 years; CG: n = 19, 70.1 ± 5.6 years). Oxygen uptake (VO2) and health profile assessments were conducted after the exercise program and after three months of detraining. The EG followed a nine-month multicomponent exercise program before a three-month detraining period. The CG maintained their normal activities. Repeated measures ANOVA showed significant increases in total heath and VO2 (p < 0.01) profile over a nine-month exercise period in the EG and no significant increases in the CG. DT led to greater negative effects on total cholesterol (4.35%, p < 0.01), triglycerides (3.89%, p < 0.01), glucose (4.96%, p < 0.01), resting heart rate (5.15%, p < 0.01), systolic blood pressure (4.13%, p < 0.01), diastolic blood pressure (3.38%, p < 0.01), the six-minute walk test (7.57%, p < 0.01), Pulmonary Ventilation (VE) (10.16%, p < 0.01), the Respiratory Exchange Ratio (RER) (9.78, p < 0.05), and VO2/heart rate (HR) (16.08%, p < 0.01) in the EG. DT may induce greater declines in total health profile and in VO2, mediated, in part, by the effectiveness of multicomponent training particularly developed for older women.
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Pujos-Guillot E, Pétéra M, Jacquemin J, Centeno D, Lyan B, Montoliu I, Madej D, Pietruszka B, Fabbri C, Santoro A, Brzozowska A, Franceschi C, Comte B. Identification of Pre-frailty Sub-Phenotypes in Elderly Using Metabolomics. Front Physiol 2019; 9:1903. [PMID: 30733683 PMCID: PMC6353829 DOI: 10.3389/fphys.2018.01903] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 12/18/2018] [Indexed: 01/14/2023] Open
Abstract
Aging is a dynamic process depending on intrinsic and extrinsic factors and its evolution is a continuum of transitions, involving multifaceted processes at multiple levels. It is recognized that frailty and sarcopenia are shared by the major age-related diseases thus contributing to elderly morbidity and mortality. Pre-frailty is still not well understood but it has been associated with global imbalance in several physiological systems, including inflammation, and in nutrition. Due to the complex phenotypes and underlying pathophysiology, the need for robust and multidimensional biomarkers is essential to move toward more personalized care. The objective of the present study was to better characterize the complexity of pre-frailty phenotype using untargeted metabolomics, in order to identify specific biomarkers, and study their stability over time. The approach was based on the NU-AGE project (clinicaltrials.gov, NCT01754012) that regrouped 1,250 free-living elderly people (65–79 y.o., men and women), free of major diseases, recruited within five European centers. Half of the volunteers were randomly assigned to an intervention group (1-year Mediterranean type diet). Presence of frailty was assessed by the criteria proposed by Fried et al. (2001). In this study, a sub-cohort consisting in 212 subjects (pre-frail and non-frail) from the Italian and Polish centers were selected for untargeted serum metabolomics at T0 (baseline) and T1 (follow-up). Univariate statistical analyses were performed to identify discriminant metabolites regarding pre-frailty status. Predictive models were then built using linear logistic regression and ROC curve analyses were used to evaluate multivariate models. Metabolomics enabled to discriminate sub-phenotypes of pre-frailty both at the gender level and depending on the pre-frailty progression and reversibility. The best resulting models included four different metabolites for each gender. They showed very good prediction capacity with AUCs of 0.93 (95% CI = 0.87–1) and 0.94 (95% CI = 0.87–1) for men and women, respectively. Additionally, early and/or predictive markers of pre-frailty were identified for both genders and the gender specific models showed also good performance (three metabolites; AUC = 0.82; 95% CI = 0.72–0.93) for men and very good for women (three metabolites; AUC = 0.92; 95% CI = 0.86–0.99). These results open the door, through multivariate strategies, to a possibility of monitoring the disease progression over time at a very early stage.
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Affiliation(s)
- Estelle Pujos-Guillot
- Université Clermont Auvergne, Institut National de la Recherche Agronomique, Unité de Nutrition Humaine, Centre Auvergne Rhône Alpes, Clermont-Ferrand, France.,Université Clermont Auvergne, Institut National de la Recherche Agronomique, Unité de Nutrition Humaine, Plateforme d'Exploration du Métabolisme, MetaboHUB Clermont, Clermont-Ferrand, France
| | - Mélanie Pétéra
- Université Clermont Auvergne, Institut National de la Recherche Agronomique, Unité de Nutrition Humaine, Plateforme d'Exploration du Métabolisme, MetaboHUB Clermont, Clermont-Ferrand, France
| | - Jérémie Jacquemin
- Université Clermont Auvergne, Institut National de la Recherche Agronomique, Unité de Nutrition Humaine, Plateforme d'Exploration du Métabolisme, MetaboHUB Clermont, Clermont-Ferrand, France
| | - Delphine Centeno
- Université Clermont Auvergne, Institut National de la Recherche Agronomique, Unité de Nutrition Humaine, Plateforme d'Exploration du Métabolisme, MetaboHUB Clermont, Clermont-Ferrand, France
| | - Bernard Lyan
- Université Clermont Auvergne, Institut National de la Recherche Agronomique, Unité de Nutrition Humaine, Plateforme d'Exploration du Métabolisme, MetaboHUB Clermont, Clermont-Ferrand, France
| | - Ivan Montoliu
- Nestlé Institute of Health Sciences, Lausanne, Switzerland
| | - Dawid Madej
- Department of Human Nutrition, Warsaw University of Life Sciences - Szkoła Główna Gospodarstwa Wiejskiego, Warsaw, Poland
| | - Barbara Pietruszka
- Department of Human Nutrition, Warsaw University of Life Sciences - Szkoła Główna Gospodarstwa Wiejskiego, Warsaw, Poland
| | - Cristina Fabbri
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,Interdepartmental Center "L. Galvani", University of Bologna, Bologna, Italy
| | - Anna Brzozowska
- Department of Human Nutrition, Warsaw University of Life Sciences - Szkoła Główna Gospodarstwa Wiejskiego, Warsaw, Poland
| | | | - Blandine Comte
- Université Clermont Auvergne, Institut National de la Recherche Agronomique, Unité de Nutrition Humaine, Centre Auvergne Rhône Alpes, Clermont-Ferrand, France
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Moreira OC, Lopes GS, de Matos DG, Mazini-Filho ML, Aidar FJ, Silva SF, de Oliveira CE. Impact of two hydrogymnastics class methodologies on the functional capacity and flexibility of elderly women. J Sports Med Phys Fitness 2017; 59:126-131. [PMID: 29249140 DOI: 10.23736/s0022-4707.17.07872-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Activities in the aquatic environment can be an interesting alternative of physical exercise for the elderly, due to several properties of water, which can favor the physiological, metabolic, perceptive, and musculoskeletal effects. The aim of this study was to compare the effects of performing two hydrogymnastic class methodologies on the functional capacity and flexibility in elderly women. METHODS Ninety women, aged 55-70 years, were divided into three groups, the control group (CG; N.=30) who did not exercise during the 12 weeks, experimental group 1 (EG1; N.=30), who performed water gymnastics classes with emphasis on lower limb exercises for 12 weeks, and experimental group 2 (EG2; N.=30), who performed conventional hydrogymnastics classes for 12 weeks. The volunteers were evaluated through the 30-second chair stand (30CST), 2-minute step test (2MST), timed up and go (TUG), static balance (SB) and chair sit-and-reach (CSR) tests. RESULTS In the intragroup comparison, there were significant improvements in the performance of 30CST tests (F=5.5, P=0.022), TUG (F=19.3, P<0.001), SB (F=5.3, P=0.025), and CSR (F=12.0, P=0.001) in EG1 and EG2. For intergroup comparisons, the EG1 presented better results than CG in CST (P<0.05). The EG2, presented better results than CG in CST, TUG, SB and CSR (P<0.05). There were no significant differences for the comparison between EG1 and EG2. CONCLUSIONS It was concluded that 12 weeks of hydrogymnastics practice improved the functional capacity and flexibility of the elderly women evaluated, and no differences were found between the two types of methodologies used.
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Affiliation(s)
- Osvaldo C Moreira
- Institute of Biological Sciences and Health, Federal University of Viçosa, Campus Florestal, Florestal, Brazil - .,Institute of Biomedicine, University of Leon, Leon, Spain -
| | - Grazielle S Lopes
- Department of Physical Education, Federal University of Viçosa, Campus Viçosa, Viçosa, Brazil
| | - Dihogo G de Matos
- Department of Sports Science, Exercise and Health of the Trás-os-Montes e Alto Douro University, Vila Real, Portugal
| | | | - Felipe J Aidar
- Department of Physical Education, Federal University of Sergipe, São Cristóvão, Brazil
| | - Sandro F Silva
- Department of Physical Education, Federal University of Lavras, Lavras, Brazil
| | - Claudia E de Oliveira
- Institute of Biomedicine, University of Leon, Leon, Spain.,Department of Physical Education, Federal University of Viçosa, Campus Viçosa, Viçosa, Brazil
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Translating novel insights from age-related loss of skeletal muscle mass and phenotypic flexibility into diet and lifestyle recommendations for the elderly. Curr Opin Food Sci 2016. [DOI: 10.1016/j.cofs.2016.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Novel ageing-biomarker discovery using data-intensive technologies. Mech Ageing Dev 2015; 151:114-21. [PMID: 26056714 DOI: 10.1016/j.mad.2015.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 05/01/2015] [Accepted: 05/28/2015] [Indexed: 12/23/2022]
Abstract
Ageing is accompanied by many visible characteristics. Other biological and physiological markers are also well-described e.g. loss of circulating sex hormones and increased inflammatory cytokines. Biomarkers for healthy ageing studies are presently predicated on existing knowledge of ageing traits. The increasing availability of data-intensive methods enables deep-analysis of biological samples for novel biomarkers. We have adopted two discrete approaches in MARK-AGE Work Package 7 for biomarker discovery; (1) microarray analyses and/or proteomics in cell systems e.g. endothelial progenitor cells or T cell ageing including a stress model; and (2) investigation of cellular material and plasma directly from tightly-defined proband subsets of different ages using proteomic, transcriptomic and miR array. The first approach provided longitudinal insight into endothelial progenitor and T cell ageing. This review describes the strategy and use of hypothesis-free, data-intensive approaches to explore cellular proteins, miR, mRNA and plasma proteins as healthy ageing biomarkers, using ageing models and directly within samples from adults of different ages. It considers the challenges associated with integrating multiple models and pilot studies as rational biomarkers for a large cohort study. From this approach, a number of high-throughput methods were developed to evaluate novel, putative biomarkers of ageing in the MARK-AGE cohort.
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