Prefrail adults are adults that exhibit signs of becoming frail. When adults become frail, they are particularly vulnerable to numerous adverse health outcomes including early mortality, functional decline, disability, and falls.
Using a randomized approach, researchers examined the use of the blood pressure medication losartan in prefrail older adults over the age of 70, and analyzed the effects of six months of losartan treatment on their physical function and the molecular pathways associated with frailty.
“We found that there were some positive changes in those who were given the losartan versus those in the placebo group,” said Jessica Lee, MD, assistant professor of geriatrics with McGovern Medical School at UTHealth Houston and first author of the study. “The frailty scores in these patients were lower after taking the losartan and they also had improved physical function. When we dug deeper into the biology behind why that might be, we found that the losartan group had improvements in their molecular levels as well, meaning changes in things like their metabolism and stress markers.”
According to Peter Abadir, MD, senior and corresponding author on the study with Johns Hopkins University, the renin-angiotensin system (RAS), a central regulator of blood pressure and sodium balance, is involved in several molecular mechanisms that are linked to frailty, including chronic inflammation, oxidative stress damage, mitochondrial decline, and impaired autophagy.
Becoming frail as we age is not inevitable, but when adults become prefrail or frail, it can affect their mental health and cause a significant decline in their life. Researchers hope this unique study can shed light on the impact of frailty and how to stop it before it is too late.
“There is still more research that needs to be done surrounding frailty,” she said. “We want these findings to reach not just geriatricians, but all primary care physicians. We hope they will also consider using these interventions in prefrail and frail adults to help improve their quality of life.”
Additional authors on the study include: Min-Ji Kwak, MD, with UTHealth Houston; Cissy Zhang, BS; Reyhan Westbrook, Ph.D.; Mariann M. Gabrawy, Ph.D.; Lolita Nidadavolu, MD, Ph.D.; Huanle Yang, MD; Ruth Marx, Ph.D.; Yuqiong Wu, MD; Nicole M. Anders, MS; Marcela-Dávalos Bichara, MD; Brian Buta, MS; Gayane Yenokyan, Ph.D.; Jing Tian, MS; Qian-Li Xue, Ph.D.; Michelle A. Rudek, Ph.D.; Anne Le, MD, Ph.D.; and Jeremy D. Walston, MD, with Johns Hopkins University; Mohammed Khadeer, Ph.D.; Luigi Ferrucci, MD, Ph.D.; Rafael de Cabo, Ph.D.; and Ruin Moaddel, Ph.D., with the National Institute on Aging; Helmy M. Siragy, MD; and Robert M. Carey, MD, with the University of Virginia; and Lina Ma, MD, Ph.D., with the China National Clinical Research Center for Geriatric Disorders.
