Using physical activity and physical function metrics to develop a ‘movement age’ in those with multiple long-term conditions (MLTCs)

Supervisors:

• Dr Joe Henson Jjh18@leicester.ac.uk 
• Dr Francesco Zaccardi
• Dr Alex Rowlands

Project:

Aim: To investigate whether daily physical activity as recorded using a wearable device and an individual’s physical function, can be used as a reliable estimation of biological age (conceptualised as ‘movement age’) in adults with multiple long-term health conditions (MLTCs).
Background: Increases in life expectancy and advances in healthcare have led to growing numbers of people living with MLTCs (1). This has significant implications for the symptom complexes, such as frailty. The frailty phenotype in MLTC’s can be an enigma, as it represents a model of accelerated biological ageing and risk of frailty (2,3) often encompassing obesity and occurring at an earlier age (4,5). A variety of biological age predictors have been generated; these have added value to the field, but require an expensive blood sample (e.g., telomere length). As such, there is a need to identify accessible outcome measures that are easily able to detect trajectories towards frailty before the phenotype is manifested.  We have previously shown that movement parameters from a wearable device are associated with biological ageing, as well as predicting frailty and mortality (6, 7). Individual components of phenotypic frailty, such as sit-to-stand transitions are also established risk factors for mortality, morbidity and disability (5). However, there is a need to embed this collective information into routine clinical care using a translatable metric.

Research Plan: The programme of work will encompass epidemiological and qualitative methodologies. These include: Systematic review (year 1): A review of the biological vs. chronological age literature, with a particular focus in MLTCs. Epidemiological objectives and methodologies (years 1-3) 1) Develop an evidence-based metric to examine the most appropriate outcomes for describing ‘movement age’. The physical activity and physical function metrics with the strongest independent associations with age (e.g.  volume/steps, sit-to-stand performance) will be selected and combined into a prediction model within a healthy reference population. 2) Determine the validity of ‘movement age’ as a risk predictor of (accelerated) ageing. The difference between chronological age and movement age will be compared in a range of readily available datasets (those with and without MLTCs). Data for objectives 1 and 2 will be collated and analysed from existing BRC datasets or those that are publicly available, e.g., UK Biobank.  Qualitative methodologies (Year 3). The feasibility and acceptability of including ‘movement age’ to inform interventions and as an interventional tool will be tested in a series of focus groups with adults with MLTCs and health professionals.  This will be facilitated through our existing PPI/E programmes.

Expected outcomes and impact: This multi-disciplinary, cross-cutting application will produce a simple, easy to understand metric (‘movement age’) that can be embedded into existing BRC programmes. By placing movement age at the clinical interface, it will also allow the facilitation of conversations around physical behaviours. This reiterates the resounding consensus from our PPI/E sessions, suggesting that the inclusion of a person-centred approach to promoting positive health behaviours should be offered in routine care.  The work could also lead to further effectiveness research (e.g. NIHR HTA grant).

References

(1) https://www.nice.org.uk/guidance/conditions-and-diseases/multiple-long-term-conditions. 
(2) Sayer AA, et al. Diabetes Care 2005 Oct;28(10):2541-2542. 
(3) Park SW, et al. Diabetes 2006 Jun;55(6):1813-1818. 
(4) Ryerson B, et al. Diabetes Care 2003 Jan;26(1):206-210.
(5) Mickute M, et al. Diabet Med 2020 Aug 26:e14393. 
(6) Chudasama Y, et al. BMC Med. 2019 Jun 12;17(1):108. 
(7) Dempsey P, et al. Commun Biol. 2022; 5: 381.

To apply
Follow the application guidelines below under How to Apply and use the application link at the bottom of the webpage.

Apply for September 2025 entry.

Complete the widening participation form (docx., 49kb) and upload it to the Proposal Section of your application. In the funding section add PHD Henson BRC studentship