Obesity's widespread increase throughout various age groups has hindered the physical activity and mobility capabilities of the elderly population. Despite the established role of daily calorie restriction (CR) up to 25% in obesity management, the safety profile in older adults necessitates further investigation. Caloric restriction (CR), despite showing promise for weight loss and improved health indicators in some adults, confronts two formidable obstacles: a substantial proportion fail to adopt the regimen, and long-term adherence proves exceedingly difficult even among those initially successful. Beyond this, there is ongoing discussion concerning the overall advantages of CR-promoted weight loss in the elderly population, due to concerns about potential exacerbations of sarcopenia, osteopenia, and frailty. Circadian rhythm's adaptability and the controlled timing of nutrition offer potential solutions to some of the problems posed by caloric restriction. Animal and human studies suggest that Time-Restricted Feeding/Eating (TRF and TRE, respectively) could be a viable method for promoting the sustained circadian regulation of physiology, metabolism, and behavioral patterns. In many cases, TRE can precede CR, although this is not a universal outcome. Consequently, the synergistic impact of TRE, optimized circadian rhythms, and CR could potentially diminish weight, enhance cardiometabolic and functional well-being, and mitigate the adverse effects of CR. However, the research and validation of TRE's feasibility as a long-term lifestyle for humans are still nascent, whereas studies on animals have consistently produced encouraging findings and provided insight into the underlying mechanisms. The following analysis delves into the potential benefits of integrating CR, exercise, and TRE to boost the functional capacity of older adults with obesity.
The geroscience hypothesis postulates that by addressing critical hallmarks of aging, we could potentially prevent or delay numerous age-related diseases, thereby increasing healthspan, the period of life lived without substantial disease and disability. Ongoing research is evaluating a variety of pharmaceutical interventions for the achievement of this objective. Scientific content experts, participating in a National Institute on Aging workshop dedicated to function-promoting therapies, presented literature reviews and state-of-the-field assessments covering studies on senolytics, nicotinamide adenine dinucleotide (NAD+) boosters, and metformin. With advancing years, cellular senescence becomes more pronounced, and preclinical studies in rodents show that the application of senolytic drugs can improve healthspan. Human-based research on senolytics is advancing with ongoing trials. The metabolic and cellular signaling functions are supported by NAD+ and its phosphorylated derivative, NADP+. Model organisms display healthspan extension when supplemented with NAD+ precursors like nicotinamide riboside and nicotinamide mononucleotide, yet human studies are scarce and present conflicting findings. Widely prescribed for glucose control, metformin, a biguanide, is believed to have pleiotropic effects that address key aspects of aging. Preclinical research indicates a potential enhancement of lifespan and healthspan, while observational studies imply benefits in the prevention of various age-related ailments. To ascertain metformin's efficacy in preventing frailty and promoting healthspan, clinical trials are progressing. Preclinical and emerging clinical studies indicate the potential for improving healthspan using reviewed pharmacologic agents. Extensive further study is vital to show the advantages and safety profile for broader application across various patient populations, as well as to evaluate long-term results.
Exercise training and physical activity exert diverse and beneficial effects on numerous human tissues, establishing them as effective therapeutic modalities for both preventing and managing the age-related decrease in physical function. To investigate the molecular basis of physical activity's effect on health improvement and preservation, the Molecular Transducers of Physical Activity Consortium is currently engaged in research. Targeted exercise regimens, particularly those tailored to specific tasks, effectively improve skeletal muscle performance and functional abilities in daily activities. buy SB 202190 The synergistic effects of this supplement's adjunctive use with pro-myogenic pharmaceuticals are evident elsewhere in this document. To enhance physical capabilities within inclusive, multi-faceted programs, auxiliary behavioral strategies promoting exercise participation and sustained engagement are being evaluated. This combined approach, incorporating multimodal pro-myogenic therapies during prehabilitation, seeks to optimize physical health before surgery, thereby promoting enhanced functional recovery afterwards. Herein, we provide a summary of the current state of knowledge concerning the biological mechanisms activated by exercise, behavioral strategies for facilitating participation in exercise, and the potential for task-specific exercise to work in conjunction with pharmacological therapies, with a particular focus on older adults. Physical activity and exercise training should be the initial benchmark of care, across diverse settings, with other therapeutic strategies considered as secondary options when seeking to increase or restore physical function.
Ligands including testosterone, steroidal androgens, and non-steroidal compounds which bind to the androgen receptor, are being developed as function-enhancing therapies for the functional limitations arising from aging and chronic ailments. These include selective androgen receptor modulators (SARMs), which act through tissue-specific transcriptional activation. A critical analysis of preclinical studies, the underlying biological processes, and randomized controlled trials focusing on testosterone, other androgens, and non-steroidal SARMs is presented in this review. General psychopathology factor The anabolic effects of testosterone are corroborated by the observable disparities in muscle mass and strength between the sexes, and the widespread application of anabolic steroids by athletes seeking to enhance muscularity and athletic performance. In randomized clinical trials, the administration of testosterone is correlated with increases in lean body mass, muscle strength, lower limb power, aerobic capacity, and self-reported mobility. Anabolic effects have been reported across a variety of populations, including healthy males, men with low testosterone, older males with mobility issues and chronic diseases, menopausal females, and HIV-positive females experiencing weight loss. Testosterone's impact on walking speed has not been consistently positive. By boosting testosterone levels, treatment increases volumetric and areal bone mineral density, and enhances estimated bone strength; it improves sexual desire, erectile function, and sexual activity; it mildly improves mood, alleviating depressive symptoms; and corrects unexplained anemia in aging men with low testosterone. Prior analyses concerning testosterone's cardiovascular and prostate safety have been inadequately large and prolonged, therefore failing to fully clarify its safety. The question of testosterone's efficacy in reducing physical limitations, preventing fractures, mitigating falls, inhibiting diabetes progression, and treating late-onset persistent depressive disorder remains unanswered. Strategies are essential to link androgen-promoted muscle mass and strength increases to better functional outcomes. pulmonary medicine Future research should assess the effectiveness of administering testosterone (or a selective androgen receptor modulator) along with multifaceted functional exercise to foster the neuromuscular adjustments needed for substantial practical benefits.
This review piece examines the foundational and emerging knowledge of how protein intake in the diet may impact muscle characteristics in older adults.
A PubMed database search was conducted to pinpoint applicable research.
In medically stable older adults, protein intakes lower than the recommended dietary allowance (RDA) of 0.8 grams per kilogram of body weight per day, significantly worsens the age-related reduction in muscle size, quality, and function. Maintaining a dietary pattern that includes total protein intakes at or marginally above the RDA, particularly including multiple meals with sufficient protein to maximize muscle protein synthesis, can support both muscle size and function. Some studies observing dietary patterns suggest that protein intake levels of 10-16 grams per kilogram of body weight per day might contribute more to enhanced muscle strength and function than to an increase in muscle size. Experimental studies employing randomized controlled feeding protocols reveal that protein consumption exceeding the Recommended Daily Allowance (roughly 13 grams per kilogram of body weight daily) does not influence lean body mass or physical function markers in the absence of stress, however, it positively impacts changes in lean body mass when coupled with intentional catabolic (energy reduction) or anabolic (resistance training) stressors. Older adults with medical conditions or acute illnesses, and particularly those suffering from malnutrition, may experience a reduction in muscle mass and function loss and an improvement in survival rates when receiving specialized protein or amino acid supplements that boost muscle protein synthesis and enhance protein nutrition. Animal protein sources are demonstrably more favored than plant protein sources in observational studies, when examining sarcopenia-related parameters.
Older adults' protein consumption, characterized by its quantity, quality, and patterning, is influenced by diverse metabolic, hormonal, and health states, ultimately shaping the protein's nutritional needs and therapeutic roles in supporting muscle size and function.
Considering the quantity, quality, and patterns of protein intake in older adults with varying metabolic states, hormonal imbalances, and health conditions, the nutritional needs and therapeutic uses of protein for muscle size and function become significantly influenced.