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Looking at frailty and intrinsic capacity through a geroscience lens: the ICFSR & Geroscience Task Force

On 22 March 2023, the Geroscience Translational Research & International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met in Toulouse, France to discuss avenues to foster the development of intrinsic capacity and frailty clinical trials under a geroscience perspective. A synthesis of these discussions and a set of recommendations are presented in this Meeting Report.

The concepts of intrinsic capacity and frailty are central to understanding human aging. Intrinsic capacity is the ensemble of all physical and mental attributes (for example, locomotion, cognition, psychology, vitality, hearing and vision) that are internal to an individual and are important for optimal function1,2. Frailty is a state of increased vulnerability, loss of resilience and high risk of adverse health events3. Therapeutic interventions to optimize intrinsic capacity and counter frailty have the potential to prevent dependence in activities of daily living (the functional end point to be avoided), promote healthy aging and extend human healthspan. Consistent with the geroscience hypothesis, interventions that target the fundamental biology of aging may both prevent the onset and reduce the severity of multiple chronic conditions and thus contribute to healthy aging. However, although the International Classification of Diseases 11th Revision (ICD-11) code ‘MG2A Ageing associated decline in intrinsic capacity’ has recently been accepted and encompasses both intrinsic capacity and frailty, there are no approved drugs for these indications.

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Fig. 1: Role of resilience in aging studies, from molecular or cellular mechanisms to overt clinical conditions.

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Acknowledgements

This task force was developed in the context of the Inspire program, a research platform that is supported by grants from the Region Occitanie/Pyrénées-Méditerranée (reference number 1901175) and the European Regional Development Fund (ERDF) (project number MP0022856). R.A.F. is partially supported by the US Department of Agriculture (USDA), under agreement no. 58-8050-9-004, by NIH Boston Claude D. Pepper Center (Older Americans Independence Centers; 1P30AG031679). Any opinions, findings, conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the USDA. We thank all task force members: S. Andrieu (Toulouse, France), D. Angioni (Toulouse, France), M. Aubertin Leheudre (Montreal, Canada); N. Barcons (Esplugues de Llobregat, Barcelona, Spain), A. Baruch (South San Francisco, USA), M. Camprubi-Robles (Granada, Spain), M. Canevelli (Rome, Italy), M. Cesari (Milan, Italy), L. Chen (Richmond, USA), A. Cherubini (Ancona, Italy), R. Correa-de-Araujo (Bethesda, USA), P. D’Alessio (Evry, France), C. Delannoy (Vevey, Switzerland), W. Dioh (Paris, France), C. Dray (Toulouse, France), W. Evans (Durham, USA), R. Hughes (Richmond, USA), S. Hüttner (Heusden-Zolder, Belgium), J. Justice (Winston-Salem, USA), A. Khachaturian (Rockville, USA), S. Kritchevsky (Winston-Salem, USA), S. LaHue (San Francisco, USA), J. Mariani (Paris, France), M. McCormick (Albuquerque, USA), R. Merchant (Singapore, Singapore), A. Neale (Richmond, USA), J. Newman (Novato, USA), S. Pereira (Columbus, USA), E. Quann (Vevey, Switzerland), J. Yves Reginster (Clarens, Switzerland), L. Rodriguez Manas (Getafe, Spain), M. Rossulek (Cambridge, USA), S. Sourdet (Toulouse, France), B. Stubbs (Novato, USA), J. Touchon (Montpellier, France), C. Tourette (Paris, France) and J. Walston (Baltimore, USA).

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Authors and Affiliations

  1. IHU HealthAge, Toulouse, France

    Philipe de Souto Barreto, Yves Rolland, Heike Bischoff-Ferrari & Bruno Vellas

  2. CERPOP, Inserm 1295, Université de Toulouse, UPS, Toulouse, France

    Philipe de Souto Barreto, Yves Rolland & Bruno Vellas

  3. Institute on Aging of the Toulouse University Hospital (CHU-Toulouse), Toulouse, France

    Philipe de Souto Barreto, Yves Rolland & Bruno Vellas

  4. Intramural Research Program of the National Institute on Aging https://www.nia.nih.gov/research/labs/about-irp

    Luigi Ferrucci

  5. National Center for Geriatrics and Gerontology, Obu, Japan

    Hidenori Arai

  6. Department of Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland

    Heike Bischoff-Ferrari

  7. Bone, Muscle & Geroscience Research Program, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada

    Gustavo Duque

  8. Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA

    Roger A. Fielding

  9. International Longevity Center-USA, Columbia University, New York, NY, USA

    John R. Beard

  10. Department of Critical Care Medicine, Queen’s University, Kingston, Ontario, Canada

    John Muscedere

  11. Hevolution Foundation, Riyadh, Saudi Arabia

    Felipe Sierra

  12. Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA

    Nathan K. LeBrasseur

  13. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA

    Nathan K. LeBrasseur

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  1. Philipe de Souto Barreto
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Contributions

P.d.S.B. wrote the first draft of the manuscript. All authors revised the manuscript with important intellectual content. All authors had final responsibility for the decision to submit for publication

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Philipe de Souto Barreto.

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Competing interests

P.d.S.B. declares consultancy fees from Pfizer. R.A.F. reports grants, personal fees and stock options from Axcella Health, other from Juvicell, other from Inside Tracker, grants and personal fees from Biophytis, personal fees from Amazentis, personal fees from Nestle, personal fees from Rejuvenate Biomed, personal fees from Pfizer and personal fees from Embion outside the submitted work. B.V. is an investigator in clinical trials at Toulouse University Hospital (IHU HealthAge, Inspire Geroscience Program). He has served as a scientific advisory board (SAB) member for Biogen, Alzheon, Green Valey, Norvo Nordisk and Longeveron, but received no personal compensation. He has served as consultant and/or SAB member for Roche, Lilly, Eisai and TauX with personal compensation. His family members have equity ownership interest in Serd publisher. He is member of the editorial board of the Journal of Prevention of Alzheimer’s Disease with no personal compensation. All of the remaining authors declare no competing interests.

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de Souto Barreto, P., Rolland, Y., Ferrucci, L. et al. Looking at frailty and intrinsic capacity through a geroscience lens: the ICFSR & Geroscience Task Force.
Nat Aging (2023). https://doi.org/10.1038/s43587-023-00531-w

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  • Published: 20 November 2023

  • DOI: https://doi.org/10.1038/s43587-023-00531-w

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