About Musculoskeletal Research
Program Importance and Goals
Musculoskeletal diseases are associated with very high levels of pain, disability and death in seniors and are the most common reason that patients seek medical care. They are particularly associated with aging.
These diseases include osteoporosis, arthritis, foot deformities, and sarcopenia (loss of muscle mass). Osteoporosis leads to approximately 300,000 hip fractures annually in the United States, a quarter of which lead to untimely death. Musculoskeletal problems also lead to falls, loss of independent function, and many other conditions that impair one's quality of life.
There are relatively few research programs in the United States that focus on the diseases of aging. Therefore, the principal goal of the Institute for Aging Research's Musculoskeletal Research Program is to promote interdisciplinary research to understand the mechanisms underlying musculoskeletal diseases and to test interventions to prevent their occurrence, progression and disabling outcomes in older adults.
The Musculoskeletal Research Program has successfully brought together four productive principal investigators with synergistic interests and a track record of innovative research. A large portion of the research has been conducted as part of the Framingham Study. Over the past 10 years, this program has had several important accomplishments:
- A multicenter study showed that a drug causing the secretion of growth hormone can increase muscle size and strength in older people.
- A randomized trial of four doses of vitamin D or placebo showed that higher doses of vitamin D can prevent falls. This work has led to new recommendations that vitamin D be prescribed in doses of 800 units per day to prevent falls and fractures in elderly people.
- An analysis of data from the Framingham Heart Study showed that foot disorders are associated with significant pain and disability among older people. This work led to a recently-funded, five- year grant from the National Institute on Aging (NIA), called the "Mobilize Boston Study," to determine the impact of foot disorders on the risk of falls in 800 community-dwelling seniors.
- 4. Work with the Framingham Osteoporosis Study has identified several regions across the genome that are linked to bone density, and geometry, and muscle mass. Also, genes that combine with lifestyle factors have been found to influence bone density. Currently, we are performing Genome-wide association studies of these phenotypes.
- Other analyses of Framingham data have shown a relationship between bone disease and heart disease. As the calcium content of bone decreases, its content in blood vessels increases. By preventing the calcium loss from bone that characterizes osteoporosis, we may also be able to prevent future cardiovascular disease.
- As a result of preliminary studies showing that mechanical vibration can improve bone density, the program is planning a clinical trial of this non-pharmacologic approach to improving bone density by having people stand on a platform that provides daily mechanical vibration to the skeleton.
This program is the home base for the Framingham Osteoporosis Study and the Framingham Foot Study, well-respected components of the famous Framingham Heart Study.
The Framingham Osteoporosis Study, under the direction of Dr. Douglas Kiel, has identified the risk factors for bone loss and fracture in seniors and is now identifying genes responsible for these disabling conditions. The Framingham Foot Study has developed assessment tools that are being used to study the impact of foot disorders on pain, function and mobility.
The Musculoskeletal Research Program has established the Bone Density Outpatient Service, which screens community-dwelling elders for osteoporosis.