Obesity's widespread increase throughout various age groups has hindered the physical activity and mobility capabilities of the elderly population. A cornerstone of obesity management has been daily calorie restriction (CR) up to 25%, but the safety of this approach for the elderly population remains incompletely understood. 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. Moreover, a persistent discussion surrounds the overall advantages of CR-triggered weight reduction in the elderly, stemming from anxieties that CR might exacerbate sarcopenia, osteopenia, and frailty. Caloric restriction's difficulties may be lessened by the adaptable nature of circadian rhythms and the strategic timing of nutritional intake. The novel strategy of Time-Restricted Eating (TRE for human studies, TRF for animal studies) offers a potential path towards maintaining the circadian rhythmicity that governs physiology, metabolism, and behavior. TRE often, though not always, culminates in CR. Therefore, the integrated consequences of TRE, refined circadian patterns, and CR could potentially result in weight reduction, improved cardiometabolic and functional health, and a lessening of CR's negative impacts. Although TRE's application as a long-term human lifestyle choice is currently in its early stages of development, animal studies have shown considerable positive results and shed light on the mechanisms involved. We investigate the scope and opportunities presented by integrating CR, exercise, and TRE for improved functional capacity in older adults experiencing obesity in this article.
The geroscience hypothesis argues that by intervening in the key indicators of aging, we can simultaneously prevent or delay a multitude of age-related diseases, thereby extending healthspan, or the period of life lived free from significant illness and disability. Several pharmaceutical interventions are under scrutiny as part of the ongoing study for this purpose. At a National Institute on Aging workshop focused on developing function-promoting therapies, scientific content experts compiled literature reviews and current assessments for senolytics, nicotinamide adenine dinucleotide (NAD+) boosters, and the use of metformin. The progression of cellular senescence is correlated with aging, and preclinical studies utilizing rodents reveal that senolytic drugs can positively affect healthspan. Human subjects are participating in ongoing senolytic studies. The metabolic and cellular signaling functions are supported by NAD+ and its phosphorylated derivative, NADP+. Precursors to NAD+, including nicotinamide riboside and nicotinamide mononucleotide, when used as supplements, show promise in extending healthspan for model organisms, yet human studies are scarce and their results are variable. Biguanide metformin is widely utilized for glucose regulation, and its presumed pleiotropic effects on the hallmarks of aging are noteworthy. Early-stage studies propose improved longevity and healthspan, and epidemiological investigations suggest preventive effects on several age-associated diseases. Investigations into metformin's potential in extending healthspan and preventing frailty are currently being conducted through clinical trials. Emerging clinical and preclinical studies reviewed highlight the potential of pharmacologic agents to boost healthspan. Substantial further research is required to establish the benefits and secure the safety for a more extensive use of this approach across different patient populations, alongside a careful assessment of long-term effects.
Exercise and physical activity therapies produce diverse and multifaceted beneficial effects across a range of human tissues, making them valuable in combating and managing age-related deterioration of physical function. Current research by the Molecular Transducers of Physical Activity Consortium focuses on elucidating the molecular mechanisms by which physical activity improves and maintains health. Task-specific exercise training is a powerful means to improve skeletal muscle performance and physical function crucial to daily activities. Tissue Slides This supplement's co-administration with pro-myogenic pharmaceuticals, as shown elsewhere in this document, could yield a synergistic result. Additional behavioral approaches, aimed at stimulating exercise participation and prolonging commitment, are under consideration as supplemental components for bolstering physical performance in integrated, multi-part programs. This combined approach, incorporating multimodal pro-myogenic therapies during prehabilitation, seeks to optimize physical health before surgery, thereby promoting enhanced functional recovery afterwards. We explore the latest advancements in the biological pathways affected by exercise, behavioral interventions designed to promote exercise adherence, and the synergistic relationship between task-specific exercise and pharmacologic therapies, focusing on the elderly population. Exercise and physical activity, implemented across various contexts, should form the foundational standard of care. Supplementary therapeutic interventions should be explored when the goal is to augment or recover physical function.
Testosterone, numerous steroidal androgens, and non-steroidal receptor-binding ligands are in development as function-enhancing therapies to address the functional impairments of aging and chronic diseases. These agents, including selective androgen receptor modulators (SARMs), activate tissue-specific transcriptional activity. This review encompasses a narrative summary of preclinical studies, the associated physiological pathways, and randomized clinical trials focusing on testosterone, other androgens, and nonsteroidal selective androgen receptor modulators (SARMs). hepatic endothelium The observed difference in muscle mass and strength between sexes, combined with the documented practice of athletes utilizing anabolic steroids to amplify muscularity and athletic performance, substantiates the anabolic influence of testosterone. Randomized trials consistently indicate that testosterone therapy leads to enhancements in lean body mass, muscle strength, leg power, aerobic capacity, and self-reported mobility. These anabolic effects have been noticed in a range of individuals, including healthy men, men with reduced testosterone production, elderly men experiencing mobility issues alongside chronic illnesses, women in menopause, and HIV-positive women with weight loss. Walking speed has not shown a consistent improvement due to testosterone. Testosterone supplementation increases bone mineral density (both volumetric and areal), improving estimated bone strength; it leads to enhancement of sexual desire, erectile function, and sexual activity; modest improvement is seen in depressive symptoms; and it corrects unexplained anemia in elderly males with insufficient testosterone. To date, research on the cardiovascular and prostate-related implications of testosterone has failed to achieve the critical mass of subjects and study duration required to ascertain safety. Whether testosterone can effectively diminish physical limitations, prevent fractures and falls, slow the onset of diabetes, and improve late-onset persistent depressive disorder remains an area requiring more conclusive research. Strategies are essential to link androgen-promoted muscle mass and strength increases to better functional outcomes. RO7589831 Subsequent investigations should consider the impact of simultaneously administering testosterone (or a SARM) and multidimensional functional exercise on the induction of neuromuscular adaptations that promote practical functional advancements.
Emerging and established data, as presented in this review, describes the effects of dietary protein on the muscle aspects of aging adults.
A search of PubMed was conducted to identify 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. Patterns of food consumption rich in protein, with intakes at or above the RDA, including meals containing enough protein for peak anabolic activity, demonstrably enhance muscle size and functionality. Observational studies have indicated that protein consumption between 10 and 16 grams per kilogram of body weight daily might promote greater muscle strength and function, exceeding the mere enlargement of muscle mass. Data from randomized controlled trials on feeding strategies indicate protein intakes exceeding the RDA (about 13 grams per kilogram of body weight daily) do not impact lean body mass or muscle/physical function assessments under non-stressful situations, but demonstrate a beneficial effect on lean body mass changes under conditions of deliberate catabolic (energy restriction) or anabolic (strength training) stressors. In the context of older adults with diagnosed medical conditions or acute illnesses, especially those suffering from malnutrition, specialized protein or amino acid supplements, that stimulate muscle protein synthesis and improve protein nutritional status, may contribute to preventing muscle mass and function loss, and improving overall survival. Observational studies concerning sarcopenia-related parameters show a tendency towards animal protein sources in preference to plant protein.
The quantity, quality, and patterning of dietary protein consumed by older adults with varying metabolic and hormonal states, and health conditions impacts the nutritional needs and therapeutic application of protein for 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.