Physical Capability and Musculoskeletal Ageing
Which factors through the course of life promote
and protect adult physical capability and musculoskeletal
health, and which increase vulnerability to accelerated
decline?
Research programme: Physical capability and
musculoskeletal ageing
Programme leader: Professor Diana Kuh
Investigator scientist: Dr Rachel Cooper
MRC studentship: David
Bann
Other LHA senior scientists: Dr Rebecca Hardy, Professor Marcus Richards, Dr Mai Stafford
External collaborators:
Maintaining physical capability (the capacity to undertake the
physical activities of daily living) and musculoskeletal function
for the maximal period of time as we grow older are important
aspects of healthy ageing, enabling people to be active and
independent for longer. Low levels or accelerated loss of
capability or musculoskeletal function pose threats to independence
and quality of life, are major causes of frailty, disability and
death, and impact greatly on health care spending. The ultimate
purpose of this programme is to provide evidence to inform the
likely timing, intensity and type of future interventions to
promote healthy ageing or delay functional decline. This programme
addresses the MRC strategic research priority for 2009-14 to
improve the chances of living a long and healthy life by driving
forward interdisciplinary research addressing health and wellbeing
from childhood to older age.
This programme takes a life course approach, investigating
biological and social factors from early life that influence later
life physical capability and musculoskeletal ageing in population
cohorts, in particular in the MRC National Survey of Health and
Development (NSHD). Studies in NSHD and other cohorts have provided
evidence that childhood socioeconomic conditions, physical growth
and maturation, and motor and cognitive development affect
objective measures of midlife capability, such as grip strength,
standing balance and chair rise performance, in addition to the
cumulative effects of adult health behaviours and socioeconomic
conditions. We have developed collaborations with experts in
endocrinology, telomere biology and genetics through the HALCyon inter-cohort research programme
for greater insights on the biology of ageing in respect of
physical capability. So far these collaborations have
found evidence that physical performance in later life is
related to greater diurnal variability in cortisol, a stress
hormone; and also that there are no clear associations between
a range of common single nucleotide polymorphisms that had been
previously associated with other ageing traits.
Main objectives for 2013-2018
There is a growing recognition of the importance of the role of
muscle in health and disease, the dissociation of muscle mass and
function with age, and the role of fat mass in moderating the links
between muscle, physical performance, disability and disease. Using
new data recently collected or planned, the research themes for the
next five years are to:
- capture the change in muscle strength and physical performance
and the progression to disability and frailty during the transition
from midlife to old age and then to investigate the lifetime
factors (from societal to underlying biology) that drive these
changes, or modify their consequences for everyday life;
- investigate the effects of lifetime body size, socioeconomic
conditions, physical activity and other health behaviours, and
reproductive function on bone and muscle mass at 60-64 years and
their clinical correlates, osteoporosis, fracture risk and
sarcopenia;
- incorporate new data on joints and osteoarthritis at the next
data collection, and study the long-term effects on these of
adiposity, muscle strength and metabolic function;
- investigate, with specialist collaborators, the biological
mechanisms that underlie musculoskeletal ageing, initially focusing
on endocrine senescence, and capitalising on the new genomic,
epigenomic, metabolomic and neurodegenerative markers as they
become available.
Top five publications 2007-2012:
Kuh D, Cooper R, Hardy R, Guralnik J, Richards M;
Musculoskeletal Study Team. Lifetime cognitive performance is associated
with midlife physical performance in a prospective national birth
cohort study. Psychosomatic Medicine 2009
Jan;71(1):38-48.
This study was one of the first to examine
cognitive and physical performance longitudinally, and in a sample
where confounding by age is not a limitation and confounding by
co-morbidity is not yet a major limitation due to the younger
relative age of the sample.
Cooper R, Kuh D, Hardy R; Mortality Review Group; FALCon and
HALCyon Study Teams. Objectively measured physical capability
levels and mortality: systematic review and
meta-analysis. British
Medical Journal. 2010 Sep
9;341:c4467.
This study provided robust and consistent
evidence for associations between physical capability and
mortality, and confirmed that these simple objective measures are
potentially clinically useful markers of ageing. The paper received
wide media coverage further raising the profile and highlighting
the importance of these measures.
Cooper R, Mishra, G, Kuh D. Physical
Activity Across Adulthood and Physical Performance in Midlife:
Findings from a British Birth Cohort.
American Journal of Preventive Medicine
2011 Oct;41(4):376-84.
This study applied our method of testing
different life course models to the study of physical activity
across adulthood and produced clear evidence of cumulative
benefits for physical performance but not strength. The findings
highlight that the general population (especially women) probably
do not undertake the correct type or intensity of activity to be
beneficial for upper body strength. This paper was one of the most
downloaded articles in the journal in 2011.
Birnie K, Cooper R, Martin RM, Kuh D, Aihie Sayer A,
Alvarado BE, Bayer A, Christensen K, Cho S, Cooper C, Corley J,
Craig L, Deary IJ, Demakakos P, Ebrahim S, Gallacher J, Gow AJ,
Gunnell D, Haas S, Hemmingsson T, Inskip H, Jang S, Noronha K,
Osler M, Palloni A, Rasmussen F, Santos-Eggimann B, Spagnoli J,
Starr J, Steptoe A, Syddall H, Tynelius P, Weir D, Whalley LJ,
Zunzunegui MV, Ben-Shlomo Y, Hardy R on behalf of the HALCyon study
team. Childhood socioeconomic position and
objectively measured physical capability levels in adulthood: a
systematic review and meta-analysis. PLoS
ONE
2011;6(1):e15564.
This study included all possible evidence
(i.e. data not only from the few existing published papers and
eight HALCyon studies but also from a number of unpublished
studies) and found robust and generalisable associations between
poorer childhood circumstances and lower capability levels.
Wills AK, Black S, Cooper R, Coppack RJ,
Hardy R, Martin KR, Cooper C, Kuh D. Life
course body mass index and risk of knee osteoarthritis at the age
of 53 years: evidence from the 1946 British birth cohort study.
Annuals of Rheumatic Disease 2012
May;71(5):655-60.
This study was one of the first to examine the influence of BMI
across the whole of life on knee OA and to investigate formally
different life course models of association. The findings show that
risk of knee OA accumulates from exposure to high BMI through
adulthood.
For a full list of publications please click here.