Research into ageing and frailty

Abstract

Research into ageing covers opportunities and challenges posed by an older population, and research to understand the ageing processes across the lifespan. The evidence base for Comprehensive Geriatric Assessment (CGA) is well established and efforts should now shift to understanding how to implement its principles across different healthcare contexts. Research around syndromes common in older people has progressed with variable success; while effective therapies for falls and cognitive impairment have been identified, older people with advanced frailty have commonly been excluded from Parkinson's disease and continence research. Research to understand the mechanisms of ageing has potential to mitigate against or treat emerging sarcopenia and cognitive impairment, and thus modify frailty trajectories. Pharmacogenetics could individualise therapeutics to reduce polypharmacy. These issues can only be addressed with development of infrastructure, capacity and expertise in ageing research. Commonly used research methodologies must be adapted to take account of frailty, cognitive impairment and functional dependency.

Keywords: ageing; cognitive impairment; frailty; research; sarcopenia.

Fig 1.

Roadmap to improve inclusion of under-represented groups, including older people, in clinical research. Reproduced with permission from Witham MD, Anderson E, Carroll C et al. Developing a roadmap to improve trial delivery for under-served groups: Results from a UK multi-stakeholder process. Trials 2020;21:694.