Does ageing have to mean more joint pain?

Published on 11 January 2013
Source: Arthritis Today

Professor Malcolm Jackson

The average lifespan of the population goes up by five hours every day. A child born tomorrow has on average a five-hour longer lifespan than a child born today. How can we keep ageing population healthy and free of conditions that traditionally affect older people? Our second new musculoskeletal ageing centre hopes to answer this question.

Integration is the keyword when trying to sum up the approach of our new musculoskeletal ageing centre – so much so that the MRC/Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA) even has the word in its name.

Based on three sites – the universities of Liverpool, Sheffield and Newcastle – each with its own areas of expertise, the aim of the new centre is to integrate all these elements to take a holistic view of the effects of ageing on the musculoskeletal system, and how getting older increases the risk of musculoskeletal disorders.

As Liverpool-based centre director Professor Malcolm Jackson puts it: “Individually, each institute has excellent facilities for basic science, pre-clinical and clinical research. Professor Tim Cawston

“However, together we benefit from shared access to high-end technology and expertise, access to model systems that cover the musculoskeletal system as a whole, and clinical expertise and resources not available in any single institute.”

Professor Tim Cawston, who heads up the research at Newcastle University, adds: “The centre is bringing together experts in muscle, tendon, cartilage and bone conditions. I’m a musculoskeletal scientist but know little about muscles. Traditionally pain is looked after by neurologists; bone and cartilage by rheumatologists and orthopaedic surgeons, and old people are looked after geriatricians. We hope to engender a more joined-up approach.”

Professor Eugene McCloskeyProfessor Eugene McCloskey, lead at the University of Sheffield, agrees: “There is huge potential in bringing us all together. We’ve got a fantastic opportunity to combine the expertise in Sheffield, particularly in bone and inflammation, with complementary expertise at Liverpool and Newcastle, to really drive basic and translational research forward rapidly in this important area.

“We have a unique opportunity to seek answers that can apply across the whole system rather than focusing on any one tissue alone.”

Research at the new ageing centre will focus a number of areas. It aims to:

• address the debate about whether age-related decline in bone density - a key feature of osteoporosis and the degeneration of articular cartilage are due to ageing alone, or whether the risk of developing these conditions increases with specific diseases in older people
• look at why ageing is accompanied by the loss of muscle mass. This emphasis on muscle loss as we age is of particular interest as the process, known as sarcopenia, has been identified as a major, if little-known, public health risk.
• investigate inactivity and obesity and their effects on the ageing musculoskeletal system
• study different types and ways of exercising to find ways to ensure that joints, bones and muscles function as we age, and to prevent age-related decline. Scientists are also looking at magnetic-resonance-based methods to produce a model of the physiology of elite athletes to understand why exercise tolerance is limited in elderly people.
• investigate whether energy-generating parts of the cell, called mitochondria, become defective during ageing and in conditions such as chronic fatigue syndrome
• investigate whether some stem cell activity could contribute to abnormal collagen production in age-related diseases

Explains Professor Jackson: “We’ll do a range of studies from basic science to applied research looking at interventions in clinics to try and prevent the onset of these musculoskeletal conditions. For example, exercise is very beneficial to the skeletal muscles as we get older to prevent weakness, but we don’t know what’s happening to the bones and joints. Some types of exercise might not be beneficial to joints as we age. We need to find out more.”

As part of its integrated approach, the centre aims to provide ageing research tools known as the ‘CIMA toolbox’ that will be available to all researchers across the three centres. This includes access to patient samples, animal models, computer software and technical expertise.

It is clear that in an ageing population there are many issues that need to be tackled in an integrated – that word again – manner. Most patients have multiple chronic diseases – the average 70+ year-old has four – that all interact with each other. Tackling this issue is one of the centre’s researchers’ biggest challenges.

Researchers in Newcastle have a strong track record in the basic biology of the ageing process, as well as clinical studies that link to important cohort studies such as the 1,000 families and the 85+ study; patients and older people who will be invaluable as specific programmes of research emerge.

The team is keen to stress that although a great part of their research will be laboratory-based, they aim to make a difference to people’s everyday lives. Says Eugene McCloskey: “We want to improve people’s lifestyles and come up with new therapies. At the end of the day, we have to deliver improved health for people as they age.”

The MRC-ARUK Centre for Integrated Research into Musculoskeletal Ageing (CIMA) is funded by £2.5m over the next five years. The Medical Research Council is contributing £1.875m and Arthritis Research UK £625,000, with support from the three universities. The other MRC-ARUK Centre for Musculoskeletal Ageing launched in November is a collaboration between the Universities of Birmingham and Nottingham.

Arthritis Today will keep readers up to date with the centre’s ongoing research.