1. Revalidatie van spieratrofie & spierzwakte Ivan Bautmans Frailty in Ageing research group www.vub.ac.be/FRIA

2. Sarcopenia Rosenberg J Nutr 1997 Age-related loss of muscle mass Roubenoff R. J Gerontol 2003 25 yrs75 yrs Muscle weakness; Physical fatigue; Loss of flexibility

3. Bauer & Sieber Exp Gerontol 2008; 43: 674-678 Neuroendocrine dysregulation

4. Acute inflammation Rapid worsening of sarcopenia Hospitalized geriatric patients with acute infections / after elective surgery –Worse muscle performance ~ Inflammation –Reduced recovery of muscle endurance Bautmans ea. AgeingClin&ExpRes 2005; Mets ea. AmJGeriatrPharmacother 2004; Bautmans ea. JGerontol 2005; Bautmans ea. BMC Geriatrics 2007; Bautmans ea. JAmGeriatrSoc 2008; Bautmans ea. JGerontol 2010; Bautmans ea. JNutrHealth&Ageing 2011; Beyer ea. ExpGerontol 2011; Bautmans ea. Gait & Posture 2011; Beyer ea. BMC Musculoskeletal 2011

5. Bautmans ea. J Gerontology 2010 Inflammatory response following surgery N=66, age 24-91 yrs, elective abdominal surgery

6. Saini ea. Ageing Research Reviews 2009;8:251–267 Inflammation Exercise ↑ ↑

7. Adapted from Williams ea Circulation 2007 70-80% Max resistance

8. N=31, Age=60-80 yrs Bautmans ea. Gerontology 2005; 51: 253-65

9. Peterson ea. Ageing Research Reviews 2010;9:226–237 15kg60kg

10. N=56, aged 68±5yrs Van Roie ea. Exp Gerontol 2013; 48: 1351-61 HIGH = 2x 10–15 rep @ 80% 1RM LOW = 1× 80–100 rep @ 20% 1RM LOW+ = 1× 60 rep @ 20% 1RM + 1× 10–20 rep @ 40% 1RM

11. Inefficient Akt/mTOR signaling pathway Preference for endurance exercise? Inflammation-reducing effect of exercise.

12. N=106, age 53–83 yrs, randomly assigned to –1yr 3x/wk strength training (60-80% 1RM) + impact exercise (jumping) –1yr 3x/wk stretching Training: –↑muscle strength –functional benefit observed in both groups

13. N=20, 75± 7 yrs Fatigue & weakness 12wk training, ±20min 3x/wk Results: –No pain –↑knee strength –↓TUG

14. N=57, age 70±7 yrs, randomly assigned to –12 wks 2x/wk resistance (2-4 stets @ 6RM) + aerobic exercise (20min @ 80% HRmax) –12 wks usual care Exercise: – ↑lean mass, ↑ muscle strength, ↑ walk speed, ↑QoL, –↓fatigue, ↓CRP

15. Beyer ea Current Opinion in Clinical Nutrition and Metabolic Care 2012; 15: 12-22

16. Pedersen & Febbraio Physiol Rev 2008; 88: 1379–1406 “myokine” pathway Pro-inflammatoryAnti-inflammatory = reduction of chronic low-grade inflammatory profile

17. N=31, Age=60-80 yrs Bautmans ea. Gerontology 2005; 51: 253-65 Acute exercise-induced response

18. Chronic effects N=31, age=60-80 yrs Bautmans ea. Gerontology 2005; 51: 253-65

19. 8wk training 3x/wk RT & RTTB ↑intra-muscular IL-6 levels!

20. Strength training in older cancer patients Literature is rather scarce Positive effects can be obtained! –Muscle performance –inflammation Dose-response relationships remain unclear Potential interfering factors –Inflammation / cachexia –Chemo/radio therapy or ‘survivor’ –Hormonal treatment

21. http://www.vub.ac.be/FRIA/SPRINT.html Thank you. ibautman@vub.ac.be