Convening in Albuquerque March 20-22, the 14^th Annual International Conference on Frailty and Sarcopenia Research (ICFSR) was the largest yet, with 441 participants (40% in person) from 29 countries, with 230 original research abstracts submitted on a wide range of topics. It is impossible to summarize such a diverse meeting, but a few highlights are below. We hope you will chime in the comments with what you learned!

The ICFSR Lifetime Achievement Award was presented to Dr. Anne Newman, who was honored for her science and mentorship over the years. Dr. Roger Fielding (Boston, USA) in his introduction noted that she is one of 10 siblings, perhaps leading her to an early understanding of the importance of collaboration.  In her keynote, Dr. Newman reviewed the history of thinking about frailty as an add-on in the Cardiovascular Health Study to the now in-depth focus in the Study of Muscle, Mobility and Aging (SOMMA).

An important recurring theme at the meeting focused on the ongoing debate on identifying sarcopenia and the challenges this presents for clinical research. In the first symposium, Dr. Peggy Cawthon (University of San Francisco, USA) gave a detailed review of the comparison between the performance of DXA, CT, MRI and D₃Creatine for measuring muscle. Dr. William Evans (Berkeley, USA) pointed out that additional work is needed before a consensus can be established. Dr. Gustavo Duque (McGill University, Canada) gave an excellent keynote presentation on osteo-sarcopenia and the communication between muscle, bone and fat that we are just beginning to understand and has many implications for future sarcopenia research.

A number of large trials presented preliminary findings. The SPRING study, presented in a symposium by Dr. Qian-Li Xue, Dr. Thomas Laskow and Dr. Nicholas Schmedding from Johns Hopkins University, Baltimore, looked at the recovery after the stressor of knee surgery and reported that baseline predictors of resilience had the biggest impact on the short-term recovery, with less impact on the long endpoint. Results of RNA gene expression profiling in the SOMMA study were presented in the third symposium by Dr. Gregory Tranah (UCSF, USA), Dr. Russell Hepple (University of Florida, USA) and Dr. Paul Coen (AdventHealth Orlando Florida, USA). Markers of denervation were found to be associated with mitochondrial respiration as well as to a lesser extent with clinical endpoints. In addition, the oxidative stress response seemed to be differentially activated between mitochondrial and cytosolic mechanisms.

Several longitudinal studies are underway comparing human and mouse aging cohorts. This included the INSPIRE project presented by Dr. Angelo Parini (Toulouse University, France) and the Study of Longitudinal Aging in Mice (SLAM) presented by Dr. Rafael de Cabo for the National Institute on Aging (Baltimore, MD). These are both impressive large-scale projects aimed a collecting and correlating data across many functional modalities with detailed biochemical and exposure markers over time. Among the complementary points between the talks was the variety of ways there are of trying to integrate this extensive data to understand the biology of healthy aging. With the accumulation of large cohorts, the potential to pool data resources and increase our understanding with advanced statistical and AI assisted analytic techniques was also a topic of much conversation.

Interventions are underway in many contexts, including nutritional analogues, exercise, even stem cells, and these dominated the oral abstract presentations. Dr. Francesco Landi (Catholic University of Rome, Italy) inspired all of us to be more personally active with mentions of the Longevity Run project. One randomized trial of an intervention presented underway is not to prevent frailty however, but to prevent frail patients from undergoing surgical procedures for which they were at high risk of complications. Presented by Dr. Shipra Arya at Stanford University, The Surgical Pause study at the VA in Palo Alto is in the final stages and has some interesting findings about how willing different specialties were to adopt the practice, how easy it was to use and how successful as a result. These findings were reinforced by the single center experience of Dr. Bradley Schmit at the University of Florida where high levels of institutional support have led to significant reductions in harm.  The abstracts are published in the Journal of Frailty and Aging for anyone who missed the meeting as there are too many to review. 

A special focus of this meeting was on providing care for older persons with frailty in diverse communities. Dr. Debra Waters, hosting the meeting from the University of New Mexico, acknowledged the history of the First Nations in and around Albuquerque on whose former land the meeting was taking place. A roundtable on Thursday afternoon discussed the work of several panelists, Dr. Nitin Budhwar, Dr. Alex DeRadke, Dr. Raj Shah and Dr. Waters, from UNM who have been working with diverse and indigenous communities in the United States and New Zealand to understand what frailty and aging means in this context. Developing culturally congruent care is critical for improving the health across diverse communities around the world, and is an especially important point for an international meeting, that seeks to bring researchers together across multiple communities.