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Keeping in Step

$5.8 million grant for BU, BMC will help elderly maintain mobility, independence

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Over the next five years, Shalender Bhasin plans to explore ways to prolong and restore older patients’ ability to walk. Photo by Thomas Hawk

Muscle biologists have described the problem, epidemiologists have emphasized its magnitude, physical therapists have worked to keep pace with it, physicians and researchers routinely see its effect. But no one has yet developed a drug to treat frailty in the elderly.

“Everyone recognizes that as people get older physical function declines,” says Shalender Bhasin, chief of endocrinology, diabetes, and nutrition at Boston University Medical Center (BUMC) and a professor of medicine at the School of Medicine. “But despite all our knowledge of how our bodies break down over time, we have no approved medical therapies to specifically address it.”

Bhasin (right) is not after a magic bullet or a fountain of youth. Rather, he and a large interdisciplinary team of researchers from several institutions are engaged in a new effort to find ways to enhance and restore mobility and independence in the elderly. This past September, BUMC received $5.8 million over five years from the National Institute on Aging to fund the Boston Claude D. Pepper Older Americans Independence Center, an interdisciplinary research effort focused on pharmacological therapies that improve physical functioning in the elderly. “We have always had many research targets and lots of data,” says Bhasin, the grant’s principal investigator. “The idea now is to collaborate to translate that work into therapies people can use.”

Named for the late U.S. senator from Florida who served in Congress from 1936 until his death in 1989, the Claude D. Pepper Center honors a man who devoted his life to public service and advocacy for the health and well-being of older adults; an avid supporter of President Franklin D. Roosevelt, Pepper urged the adoption of national health insurance and supported the creation of Social Security, a minimum wage, and medical assistance for the elderly.

Bhasin’s group was chosen from among 15 across the country competing for the grant, and the award, says Bhasin, bolsters Boston’s status as a hub of research on the elderly. The Boston chapter is one of only 11 Pepper Centers in the country.

While its name suggests one centrally located building, the Pepper Center is actually housed in four core facilities across the city: an administration and leadership core at BUMC; a function assessment and exercise lab at both BUMC and Tufts University; a systems biology lab at the School of Engineering; and a muscle stem-cell lab at the Joslin Diabetes Center. Each lab is home to a host of researchers engaged in a variety of projects: BUMC researchers are currently focusing on testosterone and similar hormones in developing drugs that will target muscle proteins to increase muscle mass and maintain mobility. In addition, researchers and clinicians from several disciplines and institutions are addressing other ailments, such as osteoporosis, hip fractures, and type one diabetes.

Over the next five years, Bhasin and his fellow researchers will explore several types of therapies, including efforts to prolong and restore older patients’ ability to walk. Walking speed, Bhasin explains, is an accurate predictor of people’s general health and has a huge impact on their quality of life. “It is often the key to maintaining independence,” he says. “Once mobility is gone, things can spiral downward.”

At the School of Public Health, Alan Jette, the director of the Health and Disability Research Institute, and a professor of health policy and management, is collaborating with several researchers on a new standardized method of assessing function and disability in older patients. Much like today’s standardized education exams, he explains, these tests are administered on computers, and generate new types of questions as the test proceeds, based on individual patients’ previous answers. “This allows you to complete the assessment more quickly,” he says, “and compare your results.” In the coming months, his team will be meeting with geriatric clinicians to refine the diagnostic, as well as with groups of older patients to discuss the physical issues they face.

Great research, however, requires great researchers, and Pepper Center members are equally dedicated to training the next generation of professionals. Rebecca Silliman, the chief of geriatrics at BUMC, and a MED professor of medicine and epidemiology, is the director of the Pepper Center’s Research and Development Core, a unit devoted to cultivating and supporting early-career investigators in aging research. Currently, four trainees — a geriatrician, a physical therapist, a rheumatologist, and an endocrinologist — participate in the program. After submitting proposals, the trainees were selected and assigned mentors, awarded funding for research projects, and in the coming months will participate in a series of teaching seminars aimed at developing skills in preparing manuscripts, grant proposals, and presentations.

“If we’re going to enhance the workforce in elderly research,” says Silliman, “we need to train people from many different disciplines to focus on the same problems. Only when they ask the same questions — and share their different answers — will we make great progress.”

3 Comments

3 Comments on Keeping in Step

  • Anonymous on 12.09.2008 at 8:41 am

    We don’t need more drugs for the frail elderly. They take enough drugs already. What they need is to do strength training a few times a week. And, of course, don’t start when you are 80 years old. Start when you are younger and build up to being strong, vibrant, and feeling young again. This way, by the time you actually are 80, you are 80 years young, not 80 years old! Now that’s going mobile drug free.

  • Anonymous on 12.11.2008 at 11:43 pm

    So good to know that research is beginning to be done so that elderly who have little else to inhibit their activities can have hope for a better lifestyle in general. OUt hope is increased with this research. And so it is important to know the research is being done. Good article.

  • Descargar on 02.13.2009 at 9:37 am

    Boston Medical Center (BMC) has received a $5,807,469 grant over five years from the National Institute on Aging (NIA) to fund the Boston Claude D. Pepper Older Americans Independence Center. BMC’s Pepper Center is one of only 11 Pepper Centers in the country.

    The Claude D. Pepper Older Americans Independence Center Program was established in honor of Claude D. Pepper, the late U.S. senator from Florida. During his five decades of public service, Pepper was an advocate for the health and well-being of older adults and built a legacy of ongoing research support to promote independence, function, and quality of life in the elderly.

    Currently there are no drugs or therapies for older people who become frail and are unable to get around, according to Shalender Bhasin, MD, chief of endocrinology, diabetes and nutrition at Boston Medical Center, professor of medicine at Boston University School of Medicine, and principal investigator of the Pepper Center grant.

    “Physical ailments and social isolation take the elderly on a downward spiral in which they lose their independence and become a burden to society,” said Bhasin. “The grant will foster collaborations among our multidisciplinary team of investigators to promote physical function mobility and cover the entire spectrum of discovery from target identification to clinical trials and function promoting anabolic therapies.”

    BMC Descargar Libros researchers are currently developing drugs that will target muscle proteins to increase muscle mass and prevent walking intolerance in older people, allowing them to maintain or restore their independence. Researchers will also conduct collaborative, interdisciplinary research to address other elderly ailments such as osteoporosis, hip fractures, and type one diabetes.

    “We are very pleased to receive this National Institute on Aging grant and are very honored to be the only Pepper Center in Massachusetts,” said Elaine Ullian, BMC president and CEO. “This grant provides BMC researchers with additional resources to expand on rehabilitation strategies to improve the lifestyle of older Americans.”

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