Stem cells may reverse symptoms associated with frailty in the elderly

Frailty is an age-related disability characterized by generalized weakness, impaired mobility and balance, poor endurance, and decline in organ physiologic reserve and loss of homeostasis. It is a syndrome of multisystem reduction in physical capacity (caused by muscle loss) that leads to loss of independence.

Speaking at the recent 10^th Malaysian Hybrid Conference on Healthy Ageing, Dato’ Dr Rajbans Singh, said the perception of people degenerating physically and mentally as they age should be changed. With proper interventions, one can age healthily into their old age instead of suffering poorer quality of life.

Currently, frailty interventions include nutrition, strengthening exercise, supplementation, and hormone replacement. “Nutrition is important,” said Rajbans. “We know a lot of older people who have bad nutrition today.” The situation is not better among the younger population, with many suffering from metabolic syndrome, hypertension and other non-communicable diseases as a result of poor nutrition.

On top of proper nutrition, exercise is equally paramount in preventing frailty in old age. Rajbans advised everyone to build up and maintain their muscle mass to prevent or slow down symptoms of frailty. Supplementation too can be helpful to support one’s lifestyle but again, Rajbans brought up the fact that supplementation does not negate the need for exercise. Finally, with regard to hormone replacement therapy, Rajbans said it was important to select the patients carefully. “In the right patient, it helps.” It has to be closely monitored so as to not cause more harm than good.

Stem cells likely to be helpful in prevention of frailty
In a regular human lifespan, stem cells population drops significantly when a person reaches their 40s onwards. Here, degeneration processes slowly overtake and overwhelm the regeneration capacity of stem cells—which is essentially of ageing.

The function of stem cells can be represented by the four Rs: replace, repair, regenerate, and rejuvenate. These processes mimic natural events of developmental biology. Rajbans suggested that perhaps a fifth function may be in order, as stem cells may rebalance the body’s biochemical processes definitely, obviating the need for traditional and costly pill-taking, injections and/or surgery. 

Stem cells are highly plastic, multipotential cells with the capacity to self-replicate. This means they can potentially generate all cell types, which in turn become more specialized stem cells that form tissues and organs. All the while, stem cells need to maintain a pool of cells like themselves for the lifetime of the individual.

In order for stem cells to function in their role in health maintenance and disease prevention, two important aspects are the support of stem cell function and prevention of conditions that may accelerate cellular loss. Cellular loss can be slowed by adopting lifestyle strategies that support health at the cellular level.

A 2017 study into the use of allogeneic (externally sourced) human mesenchymal stem cells infusions in the treatment of frailty concluded these infusions are safe and immunologically tolerated in patients. [J Gerontol A Biol Sci Med Sci 2017;72(11):1505–1512] The researchers suggested improvements seen in functional and immunological status warrant ongoing development into stem-cell based therapies for the treatment of frailty. According to Rajbans, a similar study was planned in Malaysia but was delayed due to the pandemic. He looks forward to restarting the trial at the earliest.