Institute for Ageing

Staff Profile

Professor Avan Aihie Sayer

Director, NIHR Newcastle Biomedical Research Centre & Professor of Geriatric Medicine

Background

Introduction

I am Director of the NIHR Newcastle Biomedical Research Centre (BRC) and we were delighted to be awarded £16.2M for a further 5 years funding in the most recent national competition. Newcastle’s reputation for excellence in ageing research across the translational pathway combined with the opportunity to lead the BRC, considered by many to be the ‘jewel in the crown’ of NIHR research infrastructure, were key to my decision to move to Newcastle. My clinical speciality is geriatric medicine and I have international recognition in the field of Geriatrics and Gerontology for my research on ageing, sarcopenia (the age-related loss of skeletal muscle mass and function), frailty and multimorbidity. Major research contributions to date include i) discovery of early life influences on human ageing; ii) development of a life course approach to sarcopenia and frailty using clinical, epidemiological and biological approaches; and  iii) innovative ageing experimental medicine to optimise health and healthcare in later life.

Research Priorities

The three main aims of the BRC are: to drive innovation in the prevention, diagnosis and treatment of ill-health through early translational (experimental medicine) research; to translate advances in biomedical research into benefits for patients, the health system and for broader economic gain; and to provide a key component of the NHS contribution to national and international competitiveness. So we are now perfectly positioned to exploit Newcastle’s established track record in experimental medicine and apply it to optimising health and healthcare in ageing and long-term conditions. A particular focus will be sustainable capacity building in ageing experimental medicine in the North East and wider, building on my track record of setting up a flourishing NIHR integrated academic training programme in geriatric medicine and leading an innovative interdisciplinary gerontology group in Southampton prior to moving to Newcastle.

Other Positions

I was previously an MRC Principal Investigator, Programme Leader and Professor of Geriatric Medicine at the MRC Lifecourse Epidemiology Unit, University of Southampton, where I now hold a Visiting Professor position. Other current roles include Secretary to the UK Association of Academic Geriatric Medicine, Member of the Academic Board of the European Union Geriatric Medicine Society, Associate Editor at Age and Ageing and recently Raine Visiting Professor at the University of Western Australia. I serve on a number of UK and international advisory committees and expert panels.

Research

The importance of skeletal muscle in ageing, health, and disease

The age-related loss of skeletal muscle mass and function (sarcopenia) is associated with profound adverse consequences for health including frailty, disability, morbidity and mortality. My research focuses on the life course causes, consequences and treatment of this loss of skeletal muscle. It exploits the wealth of unique data available in UK ageing and birth cohorts and includes first in world muscle biopsy studies in birth cohort participants allowing investigation of cellular and molecular mechanisms in relation to detailed clinical and physiological characterisation of skeletal muscle. A novel discovery was the association between low birth weight and sarcopenia 60 or 70 years later, suggesting that early influences were having lifelong effects on skeletal muscle. This has had led to progress in several areas of ageing experimental medicine including aetiology in terms of understanding mechanisms across the life course; prediction leading to consideration of earlier identification of individuals at risk; prevention with investigation of the role of implementing strategies earlier in life; and intervention in terms of developing novel agents.

Translational research

Discovery science has been followed by early translational studies of different types of intervention. The demonstration of an association between birth weight, leisure time physical activity and physical performance in older people led to an aetiological trial investigating differential response to an aerobic exercise intervention stratified by birth weight. An observational epidemiological study showing relationships between use of common cardiovascular drugs and reduced grip strength independent of co-morbidity has led to a major trial now underway investigating the effect of angiotensin converting enzyme inhibitors and leucine to enhance skeletal muscle function in sarcopenia. A candidate gene approach to studying gene expression in skeletal muscle found increased expression of pro-inflammatory genes and loss of strength in older men and a major ‘omics’ collaboration to identify potential drug targets is now underway.

Collaboration and Impact

I have extensive collaborative links with research groups in the UK and internationally but also across a number of key organisations to ensure that our research has maximum impact on the health needs of older people, the NHS and the UK economy. An example of patient impact has been translation of epidemiological findings on grip strength into change in clinical practice. We published a series of papers demonstrating that grip strength, as a marker of sarcopenia, was a powerful predictor of future disability, morbidity and mortality which then led to work describing both UK and global normative data. Measurement of grip is now increasingly used across UK hospital and community settings to stratify care and specialist intervention.

Taking the research forward

This research will be taken forward by the AGE Research Group which has strong links to the NIHR Newcastle BRC cross-cutting theme in ageing syndromes.  The talented researchers in this new group currently span the disciplines of biomedical research, epidemiology and academic geriatric medicine. Our vision is improving lives through world-class research in ageing and long-term conditions. We take a life course approach to understanding ageing syndromes such as sarcopenia, frailty and multimorbidity with translation of the findings into new new approaches to diagnosis, treatment and prevention.

Teaching

I have the opportunity to lecture on the MBBS and Biomedical Sciences undergraduate degree courses and enjoy supervising undergraduate and postgraduate students in research projects and higher degrees.

Publications