Sarcopenia as a Predictor of Hospital-Associated Disability in Older Adults

肌肉减少症是老年人医院相关残疾的预测因素

基本信息

批准号：
9753074
负责人：
James Andrews
金额：
$ 18.81万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-15 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9753074
关键词：
Activities of Daily Living Acute Admission activity Adult Aging American Area Biological Markers Biometry Body Composition Cessation of life Clinical Clinical Investigator Data Set Development Disabled Persons Dual-Energy X-Ray Absorptiometry Elderly Environment Epidemiology Exposure to Foundations Funding Future GDF8 gene Geriatrics Goals Hand Strength Health Hospitalization Hospitals Hour Individual Institutionalization Interleukin-6 Intervention Knowledge Learning Length of Stay Light Longitudinal cohort Measures Mediator of activation protein Medical Mentors Mentorship Muscle Outcome Outcomes Research Pathogenesis Patients Physically Handicapped Population Prospective cohort study Public Health Quality of life Reporting Research Research Methodology Research Personnel Rheumatology Risk Risk Factors Role Sepsis Serum Skeletal Muscle Structure TNF gene Testing Therapeutic Thinness Time Training Ultrasonography United States United States National Institutes of Health Universities Washington Woman adiponectin aged base career development cohort cytokine disability experience follow-up functional outcomes improved men muscle form muscle strength muscular structure novel patient oriented patient oriented research population based prevent professor programs rectus femoris sarcopenia skeletal muscle metabolism skills therapeutic target

项目摘要

PROJECT SUMMARY/ABSTRACT The overall goal of this K23 mentored career development proposal is to support Dr. James Andrews’ development as an independent, patient-oriented researcher studying the contribution of sarcopenia to hospital-associated physical disability among older adults. Dr. Andrews is an Acting Assistant Professor in the Division of Rheumatology at the University of Washington (UW). Conducting the activities proposed in this application will facilitate Dr. Andrews’ training goals of gaining hands-on experience with geriatrics patient- oriented research on clinical outcomes of acute illness, learning advanced skills in key areas (Epidemiology/Biostatistics, body composition/sarcopenia assessment, skeletal muscle metabolism), and establishing a research program examining functional outcomes of acute illness in older adults. The proposed project builds upon Dr. Andrews’ experiences studying disability in rheumatic and non-rheumatic populations and his skills in clinical outcomes research; and it leverages UW’s world-class investigators, facilities, and mentorship opportunities to allow Dr. Andrews to achieve his goal of being an independent clinical investigator. This project’s primary research objective is to test the central hypothesis that sarcopenia is a risk factor for hospital-associated activity of daily living (ADL) disability among older adults. Half of all physical disability in older adults arises in the setting of hospitalization. Aging-related sarcopenia strongly predicts long-term functional outcomes (e.g. ADL disability, death) in older adults, but the relationship between sarcopenia and hospital-associated disability is unknown. Establishing sarcopenia as a risk factor for hospital-associated disability in older adults is a critical first step in understanding pathogenesis, identifying key effect modifiers and the most at-risk individuals, and ultimately developing novel interventions to prevent hospital-associated disability for the approximately 50 million older adults hospitalized each year in the United States. Aim 1 leverages the NIA-funded Health ABC dataset to identify sarcopenia (lean muscle mass and grip strength) as a risk factor for hospital-associated ADL disability among adults aged ≥ 70 years. Aim 2 & 3 will develop an original cohort of older adults hospitalized with sepsis to identify 1.) lean mass and grip strength and 2.) serum measures of skeletal muscle metabolism as predictors of hospital-associated ADL outcomes. The proposed aims will be among the first to examine aging-related sarcopenia as a risk factor for hospital-associated ADL disability in older adults and to expose mechanism of skeletal muscle metabolism with therapeutic potential. Combined with an outstanding mentorship team and a rigorous training plan, this project will prepare Dr. Andrews’ to successfully obtain R01 funding to test novel sarcopenia-targeted interventions to prevent hospital-associated ADL disability among older adults.

项目概要/摘要这项 K23 指导职业发展提案的总体目标是支持 James Andrews 博士的发展成为一名独立的、以患者为中心的研究人员，研究肌肉减少症对安德鲁斯博士是该学院的代理助理教授。华盛顿大学 (UW) 风湿病学系开展本报告中提议的活动。应用程序将促进安德鲁斯博士的培训目标，即获得老年病患者的实践经验以急性疾病临床结果为导向的研究，学习关键领域的先进技能（流行病学/生物统计学、身体成分/肌肉减少症评估、骨骼肌代谢），以及建立一项研究计划，检查老年人急性疾病的功能结果。该项目以安德鲁斯博士研究风湿性和非风湿性人群残疾的经验为基础以及他在临床结果研究方面的技能；并且它利用了华盛顿大学世界一流的研究人员、设施和指导机会使安德鲁斯博士能够实现成为一名独立临床研究者的目标。该项目的主要研究目标是检验肌肉减少症是一个危险因素的中心假设老年人中与医院相关的日常生活活动 (ADL) 残疾占所有身体残疾的一半。老年人住院期间出现的与衰老相关的肌肉减少症强烈预示着长期的发生。老年人的功能结果（例如 ADL 残疾、死亡），但肌肉减少症与医院相关性残疾尚不清楚。将肌肉减少症确定为医院相关性残疾的危险因素。老年人的残疾是了解发病机制、确定关键效应调节因素的关键第一步和高危人群，并最终开发新的干预措施来预防医院相关的目标 1：美国每年约有 5000 万老年人住院。利用 NIA 资助的 Health ABC 数据集将肌少症（瘦肌肉质量和握力）识别为目标 2 和 3 将制定 70 岁以上成年人医院相关 ADL 障碍的危险因素。因脓毒症住院的老年人的原始队列旨在确定 1.) 瘦体重和握力以及 2.) 血清骨骼肌代谢的测量作为医院相关 ADL 结果的预测因子。目标将是第一个将与衰老相关的肌肉减少症作为医院相关 ADL 危险因素进行检查的项目之一老年人的残疾并揭示具有治疗潜力的骨骼肌代谢机制。结合优秀的导师团队和严格的培训计划，该项目将为 Andrews 博士成功获得 R01 资金，用于测试针对肌肉减少症的新型干预措施，以预防老年人医院相关的 ADL 障碍。