Professor Roman Romero-Ortuno

Summary

https://tilda.tcd.ie/frailmatics/ Increasing numbers of older people are living with frailty. Frailty is defined as dysregulation in multiple physiological systems and consequent reduction in physiological reserve. A frail person is vulnerable to decompensate and experience adverse health outcomes in the face of stressors. The higher the number of physiological systems that are dysregulated, the less physiological reserve. Despite consensus in the concept, frailty operationalisations in clinical practice are limited and a universally accepted diagnostic method does not exist. However, there is evidence that early recognition of frailty could prevent or delay adverse outcomes. The Irish Longitudinal Study on Ageing (TILDA) has collected detailed information on real-time functioning of physiological systems, with and without challenge: neurological (choice reaction time, sustained attention to response task, cerebral blood flow before and after standing), cardiovascular (continuous blood pressure and heart rate, before and after standing), and locomotor (gait with and without cognitive challenges). For this research, TILDA will offer the opportunity to host infrastructure and capacity in mining, processing and modelling its largely unexplored complex and computationally expensive "big data". We aim to discover new frailty signals and models, validate them in clinical cohorts, and lead towards new diagnostic tools to help tackle the ageing challenge.

Funding Agency

Science Foundation Ireland

Programme

President of Ireland Future Research Leaders 2018

Person Months

4

Summary

Many COVID-19 patients are experiencing symptoms consistent with severe fatigue a median of 10 weeks after their initial illness, while almost one-third of those previously employed have not returned to work. At present, most clinical and research measurements of fatigue have relied upon self-reported perception of sensations such as exhaustion or weariness. Using such tools, there is an inherent challenge for clinicians in differentiating between patients who are experiencing fatigue at a psychosocial level, versus those who are actively physiologically and neurocognitively deconditioned.The TROPIC study will use our existing clinical expertise and technology-assisted solutions to address features of post-COVID-19 fatigue by quantifying physiological signatures of adverse sequelae in adult patients previously diagnosed with COVID-19, who are now COVID-19 negative. Our suite of assessments will encompass four systems; physical deconditioning, orthostatic instability, neurocognitive deficits and respiratory sequelae. This will not only inform accurate objective diagnostics of post-COVID-19 Chronic Fatigue Syndrome, but will also guide clinicians in directing the most appropriate therapeutic interventions with maximum efficacy and specificity, bringing not only patient-related but also health system and economic benefits.

Funding Agency

Science Foundation Ireland

Programme

COVID-19 Programme

Project Type

Clinical Research

Summary

Older adults and those living with frailty (a condition of decreased physiological reserve affecting multiple systems) get higher rates of viral infections, most recently exemplified during the COVID-19 pandemic, where highest mortality is in older individuals and those with severe frailty. Yet older adults and those with frailty are not a homogenous group, and it is still unknown which individuals are most at risk from viral infections and why. There is therefore a fundamental lack of understanding in how increasing age and states of frailty affects anti-viral immunity and how this relates to frailty-associated changes in metabolic health (body composition, energy expenditure) - important influences on anti-viral responses in younger adults, yet remains unexplored in older adults. We hypothesise that by analysing the metabolic status of older adults in different states of frailty, and linking this with how their immune system activates anti-viral immunity, we will reveal crucial insights into anti-viral immunity in older and frail adults. The FRAIL-INNATE Pilot Study builds on the expertise of this clinician-scientist team (Prof. Roman Romero-Ortuno, Dr Nollaig Bourke, Dr Adam Dyer) and will be the first of its kind to address this hypothesis using a standardized method of characterizing innate immune responses in older adults across the frailty spectrum.

Funding Agency

TTMI Collaborative Pilot Study Awards - Building Engagements in Health Research 2020

Summary

The overarching aim of Nutri-Age is to investigate whether higher intakes of alkali-forming compounds present in fruit and vegetables, which are known to attenuate low grade metabolic acidosis, can protect against adverse agerelated changes in skeletal muscle, bone and metabolic health. Objectives: 1) To examine the impact of correcting age-related metabolic acidosis, via nutritional supplementation with the fruit- and vegetable-derived alkaline salt potassium citrate, on skeletal muscle protein synthesis, bone turnover and insulin sensitivity 2) To examine whether diets that are richer in fruit and vegetables (and are therefore lower in dietary acid load and less likely to induce low grade metabolic acidosis) are associated with a slower rate of decline in muscle strength, physical function, frailty status, bone density and glycaemic control in older adults in Ireland. 3) To examine food choice motivation and attitudes towards functional / fortified foods targeted at healthy ageing among older adults via an online survey (Awardee: Dr Caoileann Murphy).

Funding Agency

Tegasc

Programme

Research Leaders 2025 (Dr Caoileann Murphy)

Person Months

1

Summary

Age-related macular degeneration (AMD) is the leading cause of vision loss in the over 50's in developed countries accounting for 8.7% of all blindness worldwide. In Ireland alone, ~80,000 people live with this condition. AMD is a progressive disease characterised in early stages by drusen deposition and pigmentary changes, which progresses to late stage geographic atrophy and choroidal neovascularisation. To date, treatment options are limited to late neovascular AMD, while preventative measures such as smoking cessation and increased supplement intake are advised for early and late geographic AMD. Multifactorial in nature, AMD has no defined aetiology, however several environmental and genetic factors have been identified as associated with increased incidence and progression. Neurocardiovascular instability (NCVI) which comprises of age-related changes in blood pressure and heart-rate behaviour manifests as exaggerated blood pressure variability, orthostatic hypotension (OH), orthostatic hypertension (OHTN), and autonomic dysfunction, and has been implicated in cardiovascular risk and associated end-organ damage. Evidence suggests a link between AMD and cardiovascular disease (CVD), with several AMD risk factors also found to be associated with CVD, suggesting that disordered circulation may be a common factor in both conditions. The eye being a highly vascular organ consisting of retinal and choroidal vascular beds, would be vulnerable to NCVI if ocular vasoregulation becomes impaired with age. Indeed, associations between OHTN and BPV and increased AMD risk and poor visual acuity have been established, suggesting the deleterious effect of dysregulated blood pressure behaviour on choroidal circulation may be linked to AMD pathogenesis and progression. In the proposed study we will utilize The Irish Longitudinal study on Ageing (TILDA) dataset to examine measures of visual function and AMD status with cardiovascular/cerebrovascular function and advanced haemodynamic parameters, in this population representative cohort of participants aged ≥50 years, in an effort to establish associations between NCVI and AMD and predictors of AMD progression (Awardee: Dr Emma Connolly).

Funding Agency

Irish Research Council

Programme

Government of Ireland 2-year postdoctoral fellowship (Dr Emma Connolly)

Person Months

1