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Physical Capability and Musculoskeletal Ageing

Which factors through the course of life promote and protect adult physical capability and musculoskeletal health, and which increase vulnerability to accelerated decline?  

Research programme: Physical capability and musculoskeletal ageing (Closed 2018)

Programme leader: Professor Diana Kuh 

Programme Leader Track: Dr Rachel Cooper  

MRC Studentship: Elizabeth Wloch (completed)

Other LHA scientists: Professor Rebecca HardyProfessor Marcus Richards, Dr Mai Stafford

Maintaining physical capability (the capacity to undertake the physical activities of daily living) and musculoskeletal function for the maximal period of time as we grow older are important aspects of healthy ageing, enabling people to be active and independent for longer. Low levels or accelerated loss of capability or musculoskeletal function pose threats to independence and quality of life, are major causes of frailty, disability and death, and impact greatly on health care spending. The ultimate purpose of this programme was to provide evidence to inform the likely timing, intensity and type of future interventions to promote healthy ageing or delay functional decline. This programme addressed the MRC strategic research priority for 2014-2020 to improve the chances of living a long and healthy life by driving forward interdisciplinary research addressing health and wellbeing from childhood to older age.

This programme took a life course approach, investigating biological and social factors from early life that influence later life physical capability and musculoskeletal ageing in population cohorts, in particular in the MRC National Survey of Health and Development (NSHD). Studies in NSHD and other cohorts have provided evidence that childhood socioeconomic conditions, physical growth and maturation, and motor and cognitive development affect objective measures of midlife capability, such as grip strength, standing balance and chair rise performance, in addition to the cumulative effects of adult health behaviours and socioeconomic conditions.

Main objectives

There is a growing recognition of the importance of the role of muscle in health and disease, the dissociation of muscle mass and function with age, and the role of fat mass in moderating the links between muscle, physical performance, disability and disease. Using new data recently collected or planned, the research themes for 2013-2018 were to:

  • capture the change in muscle strength and physical performance and the progression to disability and frailty during the transition from midlife to old age and then to investigate the lifetime factors (from societal to underlying biology) that drive these changes, or modify their consequences for everyday life;
  • investigate the effects of lifetime body size, socioeconomic conditions, physical activity and other health behaviours, and reproductive function on bone and muscle mass at 60-64 years and their clinical correlates, osteoporosis, fracture risk and sarcopenia; 
  • investigate, with specialist collaborators, the biological mechanisms that underlie musculoskeletal ageing, initially focusing on endocrine senescence, and capitalising on the new genomic, epigenomic, metabolomic and neurodegenerative markers as they become available. 

Key publications 

Kuh D, Muthuri SG, Moore A, Cole TJ, Adams JE, Cooper C, Hardy R, Ward KA. Pubertal timing and bone phenotype in early old age: findings from a British birth cohort study. Int J Epidemiol 2016 Jul 10 Epub.

Muthuri S, Kuh D, Macfarlane G, Bendayan R, Cooper R. Chronic physical illness in early life and risk of chronic regional and widespread pain at age 68: evidence from the 1946 British birth cohort. Pain Epub 14 July 2016.

Kuh D, Muthuri S, Cooper R, Moore A, MacKinnon K, Cooper C, Adams JE, Hardy R*, Ward K*. Menopause, reproductive life, hormone replacement therapy and bone phenotype at age 60-64: a British birth cohort. [*joint last authors] Journal of Clinical Endocrinology and Metabolism 2016 Jul 29:jc20161828.

Cooper R, Muniz-Terrera G, Kuh D.  Associations of behavioural risk factors and health status with changes in physical capability over 10 years of follow-up: the MRC National Survey of Health and Development.  BMJ open 6(4):e009962 Jan 2016.

Wloch E, Kuh D, Cooper R.  Is the hierarchy of loss in functional ability evident in midlife? Findings from a British Birth Cohort. PLoS One, 11(5):e0155815.

Ward KA, Prentice A, Kuh D, Adams JE.  Life course dietary patterns and bone health in later life in a British Birth Cohort Study. J Bone Miner Res. 2016 Jun;31(6):1167-76.

Dodds RM, Syddall HE, Cooper R, Kuh D, Cooper C, Aihie Sayer A. Global variation in grip strength: a systematic review and meta-analysis of normative data. Age and Ageing  Jan 2016;0:17.

Mänty M, Kuh D, Cooper R. Associations of Fatigue From Midlife to Late Life With Physical Performance and Strength in Early Old Age: Results From a British Prospective Cohort Study. Psychosom Med. 2015 Sep;77(7):823-32.

Bann D, Wu FCW, Keevil B, Lashen H, Adams J, Hardy R, Muniz G, Kuh D, Ben-Slomo Y, Ong KK.  Changes in testosterone related to body composition in late midlife: findings from the 1946 British birth cohort study. Obesity (Silver Spring). 2015 Jul;23(7):1486-92.

Cooper R, Bann D, Wloch EG, Adams JE, Kuh D. "Skeletal Muscle Function Deficit" in A Nationally Representative British Birth Cohort in Early Old Age. J Gerontol A Biol Sci Med Sci 2015 May;70(5):604-7.

Bann D, Holly JM, Lashen H, Hardy R, Adams J, Kuh D, Ong KK, Ben-Shlomo Y. Changes in insulin-like growth factor-I and -II associated with fat but not lean mass in early old age: findings from a British birth cohort study.  Obesity (Silver Spring). 2015 Mar;23(3):692-8.

Dodds RM, Syddall HE, Cooper R, Benzeval M, Deary IJ, Dennison EM, Der G, Gale CR, Inskip HM, Jagger C, Kirkwood TB, Lawlor DA, Robinson SM, Starr JM, Steptoe A, Tilling K, Kuh D, Cooper C, Sayer AA.  Grip strength across the life course: normative data from twelve British studies.  PLoS One. 2014 Dec 4;9(12):e113637.

Cooper R, Hardy R, Bann D, Aihie Sayer A, Ward KA, Adams JE and Kuh D. Body mass index from age 15 years onwards and muscle mass, strength and quality in early old age: findings from the MRC National Survey of Health and Development. J Gerontol A Biol Sci Med Sci. 2014 Oct;69(10):1253-9.

Bann D, Cooper R, Wills A, Adams J, Kuh D on behalf of the NSHD scientific and data collection team. Socioeconomic position across life and body composition in early old age: findings from a British birth cohort study.  Journal of Epidemiology and Community Health Jun 1;68(6):516-23.

Bann D, Kuh D, Wills A, Adams J, Brage S, Cooper R on behalf of the NSHD scientific and data collection team.  Physical activity across adulthood in relation to fat and lean mass in early old age: findings from a British birth cohort study.  American Journal of Epidemiology 2014 May 15;179(10):1197-207.

Cooper R, Strand BH, Hardy R, Patel KV, Kuh D.  Physical capability in midlife and survival over 13 years follow-up in a British birth cohort study.  British Medical Journal 2014;348:g2219.

Kuh D, Karunananthan S, Bergman H, Cooper R.  A life-course approach to healthy ageing: maintaining physical capability.  Proceedings of the Nutrition Society 2014 Jan 23:1-12.

Bann D, Wills A, Cooper R, Hardy R, Sayer AA, Adams J, Kuh D on behalf of the NSHD scientific and data collection team. Birth weight and growth from infancy to adolescence in relation to fat and lean mass in early old age: findings from the MRC National Survey of Health and Development. International Journal of Obesity 2014 Jan;38(1):69-75.

Cooper R, Stafford M, Hardy R, Aihie Sayer A, Ben-Shlomo Y, Cooper C, Craig L, Deary IJ, Gallacher J, McNeill G, Starr JM, Kuh D and Gale CR on behalf of the HALCyon study team. Physical capability and subsequent positive mental wellbeing in older people: findings from five HALCyon cohorts. Age 2014 Feb;36(1):445-56.

Kuh D, Wills AK, Shah I, Prentice A, Hardy R, Adams J, Ward K, Cooper C on behalf of the NSHD scientific and data collection teams. Growth from birth to adulthood and bone phenotype in early old age: a British birth cohort study. Journal of Bone and Mineral Research 2014 Jan;29(1):123-33.

For more publications please look on our findings page which can be found by clicking here.