Knowledge of the mechanisms of frailty is of the greatest interest at the present time. We have recently gone from attempting to solve the problem of ageing and lengthening life to increasing the quality of life of the elderly, in accordance with the initial descriptions of the objectives of geriatrics. The description of the geriatric syndrome of frailty changed the perspective and even the paradigm of ageing studies both in the clinical sphere and at the basic level.
To study the mechanisms involved in the development of frailty in order to propose interventions. We will also analyse the mechanisms of such interventions by collecting a large amount of data whose computer analysis will lead us to conclusions which, in cooperation with clinical groups, will draw us closer to the general aim of delaying frailty and especially its development into dependence.
This programme is structured in three overall lines:
1.- Study of the mechanisms involved in the development of frailty
The mechanisms causing frailty will mainly be addressed in studies based on the role of bioenergetics, with special focus on mitochondria. First of all, the mechanisms by which mitochondrial disorders can bring about the appearance of fragility will be studied; secondly, the way energy collapse affects the nervous system will be examined, especially the delicate balance of neurotransmitters, with special application to Alzheimer’s disease; and thirdly, fundamental aspects of the mitochondrial function and mitochondrial genetics, whose alterations lead to early ageing and especially to the early appearance of frailty, will be dealt with.
We will similarly analyse biomarkers. Several groups are combining great endeavours (some have evolved into a major European project led by Dr Rodríguez Mañas, who is also the Scientific Director of the CIBERFES) to study frailty biomarkers. It is not a question of performing complex laboratory analyses to identify a syndrome which can easily be diagnosed in the clinic, but of biomarkers of the frailty risk in the elderly and of the risk of frail persons going on to become dependent. This risk is what we are seeking to determine by means of biomarkers.
2.- Study of the mechanisms enabling interventions to delay the appearance of frailty
This second line does not consist so much of designing interventions as of studying the mechanisms by which these interventions are useful for delaying and even treating frailty. In this approach, CIBER is presenting Physical Exercise Programmes, which may be considered for both people and animals, in the latter providing access to samples that cannot be obtained from humans for ethical reasons.
Another important aspect is that of studying the mechanisms by which nutrition, and especially certain substances that may be considered diet complements, may delay the appearance of frailty. Special attention is given to polyphenols and in general to the ingredients in the Mediterranean diet. Some CIBER groups are highly interested in studying a hormone known as melatonin, understood to be and taken as a supplement, and its effects in preventing the appearance of frailty.
Lastly, sleep and the regulation of wakefulness/sleep cycles, whose significance was recently acknowledged by the Nobel Foundation, will be studied. There are groups in the Network with great experience in this field. At our CIBER we will analyse how the regulation of wakefulness/sleep rhythms and their analysis by means of technological approaches applied to health may improve the quality of life of senior citizens.
3.- General analysis of data with the assistance of technologies applied to health, with very special attention to bioinformatics, which enables us to handle large masses of data.
All the data are analysed by means of bioinformatics studies, which will make up the large amount of basic information we estimate we shall be able to compile and then apply to the clinical field, which is the main objective of this line of the CIBERFES.
One long-term objective is to set up a centralised database with a large amount of information collected by the different CIBERFES groups, and to make this available to all the CIBER groups and the Scientific Community.