New Concepts For Research In Elderly Care And Healthy . - Free Download PDF

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New concepts for research in Elderly Care andHealthy Ageing.Game changers for prevention and treatmentP.Eline SlagboomLeiden University Medical Centre (LUMC)

Outline Integrated Approaches in ResearchWhy investigate ageingWhat is healthy ageing by natureBy nurture, how to monitor and influence healthy ageingGame changers: Integrating basic, biomedical and medical researchLUMC : Medical Research Profile on AgeingNational: Dutch Society for Research on Ageing (DuSRA)More systematic observation of elderly in the clinicNot treatingTeaching

Age is the strongest risk factor for common diseasesCVDcancerinfluenzaAlzheimer’s20 % of life EU citizen spend in disability 65 doubles before 2060 85 triples before 2060 Co-morbidity, polypharmacy, heterogeneity/biological age ---personalized medicin

Healthy Ageing by nature.Leiden Longevity Study (3500 individuals)/a/g

The genome of the oldest old in the EUJoris DeelenHum Mol Genet 2014 EU longevity researchAPOE ; Chrome 5q3.33 ; EBF1 Worlwide longevity research (EU, US, China)

Leiden Longevity StudyNature: drivers of healthy ageingNature : Intrinsic immune and metabolic health:Clinical Variables, Metabolites, Imaging (brain)Morbidity, MortalityEnergy metabolism/nutrient sensing: Lipids, Insulin, Thyroid, mTORBonusCan you influence it ?616-Jun-16

Neuro-cardiovascularAlbert Einstein SPLuiz Vicente RizzoEdson AmaroFabio Gazelato de Mello FrancoMusculoskeletalClassifying individuals-Developing biomarkers-Insight in heterogeneityImmune/MetabolicHealthUnderstanding pathways-BiomechanicsBiologicalagingPatient based interventions-Improving therapies-Cellular mechanisms-Improving preventions-Molecular pathways-Insight in responses to stress

Growing Old Together (GOTO) Study design13-weeks intervention 12.5% reduced dietary intake 12.5% increased physical activityBaselineBefore baseline: FFQ IPAQ Accelerometer 24 hr blood glucose At baseline : Blood, fat, muscleEndDuring intervention 4 x 24h recalls Diary Hunger and satietyquestionnairesOne week before end: Accelerometer 24 hr blood glucose Blood, fat, muscleResearch questions: Is this “common sense” lifestyle interventionfeasible and healthy for all older adults ( 60 yearsold)?

Healthy Ageing Result of GOTO intervention 60-70 year old : Feasible : window of opportunityBuddy effect and coachingWell-being improvedSleep improvedMetabolic health improvedLongevity family members not different from spouse But: Heterogeneous responses

GOTO: Weight change after 13 weeks

GOTO: Change in systolic blood pressure after 13 weeks

GOTO Change in insulin after 13 weeks

Healthy Ageing Heterogeneous responses Research in Public/Private CollaborationHow to understand: blood, fat and muscle studiesHow to monitor: Biomarkers (Brainshake, Pfizer, Philips)How to motivate : AGO study in 60

Monitoring Behavioral patternsSensors of heart rate variability, accelerometers etc.

Wearables not tested in elderly ‘in the wild’.Investigation of 35 subjects 60-70 years

Washing dishes (3 minutes)

Organize bookshelf (3 minutes)

Vacuuming (3 minutes)

Cycling (15 minutes)

Evaluation of Interventions

Molecular Monitoring: BIOMARKERSBig data in the right context (BBMRI)EpigenomeGutmicrobiome

BIOMARKERS : Metabolites in blood/urine monitoring tissue conditionsSuhre et al. PLoS ONE November 2010 Volume 5 Issue 11

TopicStudyMigrainLUMINA/CHARM/RVCLFollowUp (y) CasesNTR VU4.4ERF EUMCDementiaVUMC Alzheimer3EUMC 0400NTR VU4.4100010009001000All cohortsLLS LUMC109982313EUMC 85 1-114001200Alpha/Omega MUMC5.5459476900STEMI UMCG400UNCORBIO UMCU3PROSPER LUMC3.24187145Type 2 Diabetes CODAM MUMCMaastricht Study MUMCDZS West-Friesland VUMCGARP LUMC12001010002-6412203047620301000EUMC OA6.6793CHECK8981LifeLines22 cohorts in KA LUMC500 FG579854HELUIS AMCOmics1256CardioVascularDiseaseBIOMArCS EUMCOsteoarthritis439NESDA VUEUMC ecificGeneric profiles

Metabolites and Mortality (N 40.000)Personalised/stratified risk assessment

GOTO: Beneficial Profile after intervention* Independent of weight changeWurtz 2015 Circulation; Stancacova 2012 Diabetes; Mahendran 2013 Diabetes Care

Stay Fit, Stay VerticalAging isInevitable

Outline Integrated Approaches in ResearchWhy investigate ageingWhat is healthy ageing by natureBy nurture, how to monitor and influence healthy ageingGame changers: Integrating basic, biomedical and medical researchLUMC : Medical Research Profile on AgeingNational: Dutch Society for Research on Ageing (DuSRA)More systematic observation of elderly in the clinic (TENT)Not treatingTeachingNational Biobanking : BBMRI.Nl

Triaging Elderly Needing Treatment (TENT)Standardized vitality assessment and biobanking28Grote visite poli31 mei 2016

Not Treating or Nutritional Medicin292016

Master Vitality and AgeingDiscover the world at Leiden University

Master Vitality and Ageing focus onContent Biological mechanismes of ageing Older individuals Organisation of ageing society Skills Communication in science Evidence – research Academic Skills

After graduationScientific careerFurther education in science(leading to a PhD degree)Medical careerFurther medical education(geriatrics, internal medicine, general practice)Management careerManagement position in care organisations orgovernmental organisations

BBMRI-NL : Biobanking and BioMolecular resourcesResearch Infrastructure in The Netherlands Nation wide biobanking infrastructure Founded in 2009: Dutch node of EU BBMRI-ERIC 200 Dutch biobanks Sharing of Molecular, Clinical, Imaging Data. Accessible forscientific community. Big data combined to stimulate personalized /stratifiedmedicine Dutch National Tissue Bank PortalJune34 12, 2016

Ambition BBMRI-NLJune35 12, 2016

Website BBMRI.nlCataloguewith 200biobanksELSI center ofexpertiseTools &ApplicationsJune36 12, 2016http://www.bbm

BBMRI.nl Ethical, Legal, Social issuesthe site for the public, donors, politics and pressJune37 12, 2016http://www.bbmri.nl/wp-

Music, Science and HumorCollaborations with Brasil

Albert Einstein SP Luiz Vicente Rizzo Edson Amaro Fabio Gazelato de Mello Franco. Growing Old Together (GOTO) Study design ... Depression NESDA VU 6 1200 400 NTR VU 4.4 1000 1000 EUMC depression 900 1000 ... BBMRI.Nl Outline Integrated Approaches in Research . 28 Grote visite poli 31 mei 2016 Triaging Elderly Needing Treatment (TENT) ...