Think back over the day you just spent in the lab, your clinical setting, or the classroom. Think of the hypotheses you advanced, the care you provided, or the skills you shared. They represent the cutting edge of geriatrics today, but we also need to stop and remember that most if not all of that work started here: In the pages of research journals as questions that puzzled, perplexed, or just plain bugged us as experts in older adult care. Dedicating time and attention to those questions is key, because finding answers is the fuel that powers geriatrics expertise.
It is also the fuel behind one of our most powerful programs here at the American Geriatrics Society (AGS): our U13 conference series funded by the National Institutes of Health (NIH) National Institute on Aging (NIA).
For more than a decade, our AGS-NIA U13 conference series has advanced geriatrics expertise by giving us the time and freedom to explore those questions that puzzle, perplex, or bug us. Researchers gathered at last year's conference, for example—reported on in the Journal of the American Geriatrics Society (JAGS; Colón-Emeric et al., 2019)—hope their work can help yield hard evidence to address the range of bone and soft tissue disorders that contribute to falls, fractures, and muscle loss—a key concern for us all as we age.
According to Cathleen Colón-Emeric, MD, MHSc, FACP, AGSF, who co-chaired the AGS-NIA conference in March 2019:
Falls, fractures, and muscle loss all have a major impact on our health as older adults, not only because they stop us from keeping active but also because that inactivity can have a ripple effect on all aspects of health and quality of life…. By looking at some of the key and interrelated health conditions that can contribute to falls, fractures, and muscle loss, we hope we can contribute to closing knowledge gaps as we develop better care.
The AGS-NIA U13 conference brought together more than 80 national and international experts to discuss the present and future state of research on age-related aspects of osteoporosis and soft-tissue disorders (Colón-Emeric et al., 2019). The conference came at a pivotal time. As the prevalence of bone and soft-tissue disorders mounts—it is estimated, for example, that one in four older women and one in 20 older men already have osteoporosis—so too do alarming and interrelated consequences (Colón-Emeric et al., 2019). Osteoporosis and deterioration in soft-tissue health are known to increase risks for falls, fractures, and frailty, which in turn limit health, safety, and independence as mobility begins to wane (Colón-Emeric et al., 2019).
For older adults and caregivers, the challenge rests in preventing these conditions as often as possible. For health professionals, that means addressing an even broader set of questions about when and how these conditions arise, and what can be done to reduce risks as much as possible. Attendees at the AGS-NIA U13 conference hope the answer lies in a deeper look at fundamentals: What we know, what we do not, and what we can change when we jointly consider age, bone and muscle health, and the health conditions linking them.
Conference attendees noted that a key research priority must be identifying the “prime movers in biology,” or the principal treatment targets that can address the root causes of bone and soft-tissue concerns (Colón-Emeric et al., 2019, p. 2). Refining our knowledge of how medications and other interventions such as diet and exercise impact individual cell types—and even whole-body systems—will be key to improving care for us all as we age (Colón-Emeric et al., 2019).
At the same time, current perspectives on health care and health research also need to change. Developing medications to address bone and soft tissue changes that come with age can be uniquely challenging, because age itself is not a research endpoint recognized by the U.S. Food and Drug Administration (Colón-Emeric et al., 2019).
But measures of muscle and bone function may prove helpful in this regard as they hold promise for contributing to the development of treatments to delay, prevent, or reverse a key contributor to age-related decline: senescence, loss of our body cells' power to divide and grow as they did when we were younger (Colón-Emeric et al., 2019). Concurrently, conference attendees also asserted that health care needs to embrace a “life-course approach” to treating bone and soft tissue concerns, as body composition and muscle function change as we grow older (Colón-Emeric et al., 2019, p. 3).
“We know more today than we ever have about the impact of bone and soft-tissue disorders on quality of life and risks for declining health and even death,” stated Bruce Troen, MD, AGSF, co-chair of the meeting. “We now need to chart a course toward identifying risk factors, health disparities, and promising interventions to treat and prevent these concerns. We're confident our work at the conference resulted in a roadmap for progress” (AGS, 2019. para. 8).
The AGS-NIA U13 conference on osteoporosis and soft-tissue disorders was the second in a three-part series designed to provide updates on cutting-edge research and facilitate collaboration among experts. Editorials summarizing this meeting and an earlier gathering on sensory impairment and cognitive decline are both available for free from JAGS. The third AGS-NIA conference on cancer and cardiovascular disease will take place in fall 2020.
This research was supported by the NIA of the NIH under Award 5U13AG054139. The content is solely the responsibility of the authors and does not necessarily represent the views of the NIH, the NIA, or the U.S. government.
Sunny Linnebur, PharmD, FCCP, FASCP,
President, American Geriatrics Society
- American Geriatrics Society. (2019, December3). Bone & muscle health can “make or break” care as we age; Geriatrics experts hope these new insights can strengthen science's response [news release]. Retrieved from https://www.americangeriatrics.org/media-center/news/bone-muscle-health-can-make-or-break-care-we-age-geriatrics-experts-hope-these
- Colón-Emeric, C., Whitson, H. E., Berry, S. D., Fielding, R. A., Houston, D. K., Kiel, D.P., Rosen, C. J., Seldeen, K. L., Volpi, E., White, J. P. & Troen, B. R. (2019) AGS and NIA bench-to-bedside conference summary: Osteoporosis and soft tissue (muscle and fat) disorders. Journal of the American Geriatrics Society, 68(1), 31–38. doi:10.1111/jgs.16248 [CrossRef]