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Akutgeriatrie

As Germany is one out of three nations with the highest proportion of old people, we have right now almost 13 millions of people being 70 years and older. To deal with or even have a chance to handle the increasing risk of long-term care of geriatric patients, a high quality multidisciplinary and multiprofessional research approach is strongly required in an international setting. One main factor of long-term care is immobility caused by muscular deficiency. Sarcopenia as a progressive and generalized skeletal muscle disorder that is associated with increased likelihood of adverse outcomes including falls, fractures, physical disability and mortality. So muscle is one of the key organs for healthy aging. The overall mission of our research group is to offer precision medicine (diagnostic, prevention, therapy) for musculoskeletal health in the 21st century. Munich, the capital of Bavaria, Germany has 1.5 Mio. inhabitants in the city. The research structure of the medical faculty of the University Hospital of Munich (LMU) is divided into six areas. Aging research is planned to be added to the already established area “Medicine for the society”. Therefore, in December 2014 the University Hospital of Munich (LMU) established at the downtown campus the first academic geriatric ward in Bavaria.The geriatric department is based at the Medical Department IV of the University Hospital, LMU Munich, Germany at the downtown campus led by Professor Dr. Martin Reincke who holds the chair for endocrinology. The Medical Department IV is a multidisciplinary clinic for internal medicine, emergency medicine, endocrinology, nephrology, rheumatology, angiology and infectious diseases. He is involved in national and international trials, in designing registries and trials including investigator initiated trials, and is active as speaker, author, reviewer, and advisor. Therefore, a great experience in the endocrinological field for investigating the hormonal causes of sarcopenia is available. With more than 4.5 Mio. EUR external and third-party raised funds and more than 1,000 cumulative impact factors per year the Medical Department IV is a strong scientifically orientated department. Regarding student teaching, the Medical Department IV renders more than 5,000 teaching hours which is about 14% of the total teaching amount of the medical faculty.

We are an interprofessional clinical research unit at the University Hospital of Munich (LMU) in cooperation with different other institutions for basic research (animal models within those Prof. Dr. med. Thomas Gudermann and Dr. Vladimir Chubanov (Walther Straub Institute of Pharmacology and Toxicology, LMU; Prof. Dr. Dr. med. Eric Hesse (Institute of Molecular Musculoskeletal Research, KUM); Prof. Dr. med. Martin Reincke and Prof. Dr. Jan P Tuckermann (Endocrinology, Department of Medicine IV, KUM); Prof. Dr. med. Jochen Seißler (Diabetology, Department of Medicine IV, KUM); Prof. Dr. med. Wolfgang Böcker and Dr. Maximilian Saller (Department of General, Trauma and Reconstructive Surgery, KUM); Prof. Dr. Eckhard Wolf and Dr. Veronika Schönitzer (Institute of Molecular Animal Breeding and Biotechnology of the LMU) and clinical aspects (especially in cooperation with the osteological center of the KUM, Prof. Dr. Ralf Schmidmaier and Prof. Dr. med. Wolfgang Böcker). Our research interest focuses on preventive gerontology with emphasis on sarcopenia, a geriatric syndrome curtailing active and healthy aging. We could contribute clinical patient cohorts and use cases (from acute geriatric ward, day clinic and outpatient at our clinic), a registry for sarcopenia and data from population-based studies of older adults aged >=65 years such as (KORA)-Age study at the Helmholtz Zentrum München in Germany (covering 1.079 patients with a prevalence of sarcopenia around 5-15% (>65->80years) and a 3 years Follow-up (n=822) led by Prof. Dr. Barbara Thorand (Institute for Epidemiology, Helmholtz Zentrum München)) or data of the Statutory Health Insurance Physicians in Bavaria (KVB), covering 1.6 Mill. Patients older than 70 years of age in the outpatient clinics. Aims of one of our projects are (i) how to optimize and standardize the diagnosis over in- and outpatient settings of sarcopenia, (ii) identification of modifiable risk factors such as clinical and molecular mechanisms by primary muscle cell cultures as well as laboratory assessments,

(iii) improvement of interdisciplinary treatment and prevention of sarcopenia as a new ICD-code-based geriatric syndrome. As partner within the GAME (Global Alliance of Medical Excellence) consortium and the EUGLOH (European University Alliance for Global Health) our clinic provides international and European structures for dissemination and sustainability for PhD and undergraduate education in the field of global health with the goal to establish an international consortium for preventive geriatrics and gerontology research.

The project can profit from the established structure from the LMU to support young scientists. As part of its institutional Strategy LMUexcellent, LMU Munich has introduced the LMU Academic Career Program, which supports outstanding early-career researchers at each stage of their academic career – from doctoral studies to the first appointment to a faculty position. Specifically, postdoctoral researchers at LMU can benefit from Investment Fund / Junior Researcher Fund (seed funding) and the Travel Grant Scheme. The University has implemented and continues to extend a central infrastructure, which provides an ideal environment by fostering excellent conditions for research and the next generation of academics. These include the Center for Advanced Studies, the GraduateCenterLMU, and the LMU Center for Leadership and People Management and LMU’s various Research Services. At the doctoral level, the GraduateCenterLMU, as the central service unit for all matters related to doctoral studies offers a range of training courses for doctoral candidates from all disciplines. So, all PhD- and MD-students recruited will enter one of the structured PhD- or MD/PhD-programmes at the LMU, established by the Munich Medical Research School. These provide structured and mandatory mentoring (with regular project reviews by experienced scientists), curricula (lab courses, seminars addressing research and professional topics), and platforms for information exchange for all participants. Integration in these structured PhD and MD/PhD programmes guarantees strict surveillance of time spans required for the thesis and supports its conclusion within regular time spans (i.e. 3.5-4 years)

Prof. Dr. Michael Drey, M.Sc. has a full professorship for geriatrics (W2) at the Medizinische Klinik und Poliklinik IV at the KUM. As head of the geriatric department, which was founded in December 2014 at the medical clinic and outpatient clinic IV at the University Hospital of Munich, Michael Drey is responsible for the establishment of a geriatric day clinic at the downtown campus to go into service in April of the year 2020 and a planned geriatric department at the campus Großhadern. With this clinical infrastructure, the translational research with basic to clinical care should lead finally into a center for geriatric research at the KUM. Based on the research focus in sarcopenia, an outpatient clinic for sarcopenia for patients older than 70 years of age including a sarcopenia registry for this cohort was established in 2018. Main research focus is sarcopenia and its neurodegenerative aspects, including biomarker studies, nutrition and exercise interventions studies on a national and international level. Michael Drey holds a master degree in Medical Biometry.

Research Group leader: Dr. med. Uta Ferrari, MPH studied human medicine in Goettingen and the LMU Munich with stays abroad in the US, UK and France (University of Illinois, Urbana-Champaign; Columbia University in New York; Princess Royal Hospital, Haywards Heath, England; Necker-Enfant and Georg Pompidou in Paris). She wrote her doctoral thesis in basic research in neuropharmacology at the Max Planck Institute for Psychiatry in Munich and began as a physician for clinical training and research in 2003 at the University Hospital of Munich. She received research awards from the LMU/DAAD for conducting a research project “Health Care and the Social Contract: The United States and Germany” at the University of Illinois / Urbana Champaign, USA and from MSD and DMKG with a research stay in Copenhagen, Denmark. In order to get to know the big picture of research after years of basic research, she completed the postgraduate Master of Public Health. She wrote her master thesis at the Bavarian statutory health insurance physicians’ association (KVB) and worked there as a project manager in the Strategy and Corporate Development department. In addition to clinical, epidemiological and laboratory experience, she has been working as a clinical epidemiologist, which she habilitated in, and study physician in research teams of the Medical Clinic and outpatient clinic IV of the University of Munich since 2009. She is responsible for conception, project and data management, clinical assessment of participants and contacts to cooperation partners for European and international clinical and epidemiological studies. Projects examples are “Subclassification, prediction and prevention of type 2 diabetes”, “Prediction of the efficacy of metformin” in cooperation with the KVB and outpatient clinics, representation of the LMU Munich in the ICT EU - Project GENESIS about weather/climate change and health, “Neuromuscular Diseases and Sarcopenia” within the EU Project H2020 MSCA-ITN KEEP Control or early experience intervention study "Step by step with Fortifit" in sarcopenia. Ms. Ferrari supervised numerous medical doctoral students as well as PhDs in biology and pharmacology in Germany, and in addition in Nepal, Cameroon and Bangladesh as part of her collaboration with the Center of International Health at the LMU with her global research focus on non-communicable diseases (NCDs). With her interdisciplinary background in neurology and endocrinology / diabetology, she has repeatedly dealt with the organ muscle and since 2017 with its disease sarcopenia in the geriatric department, headed by Prof. Dr. med. Michael Drey. They founded in 2018 the Sarcopenia Register in Munich in cooperation with the endocrinological laboratory, the Biobank of the Friedrich Bauer Institute and the Osteological Centre of the University Hospital Munich, LMU. Main focus of the project with the Friedrich Bauer Institute is on differential diagnosis of neuromuscular diseases using primary muscle biopsies and blood markers. The focus of the cooperation with the Osteological Center is on patients with osteoporosis on muscle-bone interaction and in cooperation with the endocrinological laboratory the further interaction of endocrinological laboratory markers such as IGF-1, GH, leptin, insulin, sexual and steroid hormones are analysed in the context of precision medicine for healthy and successful aging.

Main publications (Michael Drey):

  • Gempel-Drey G, Drey M.Medicinal products for geriatric patients in Germany : Current status of regulatory requirements and clinical reality. Z Gerontol Geriatr. 2019 Apr 30.
  • Ferrari U, Drey M. Sarcopenia - how does the patient restore muscle strength again. MMW Fortschr Med. 2019 May;161(8):45-48
  • Drey M, Henkel M, Petermeise S, Weiß S, Ferrari U, Rottenkolber M, Schmidmaier R.Assessment of Bone and Muscle Measurements by Peripheral Quantitative Computed Tomography in Geriatric Patients. J Clin Densitom. 2018 Oct 12
  • Hoffmann U, Drey M, Thrun JM, Obermeier E, Weingart C, Hafner K, Sieber C.The role of wrist monitors to measure blood pressure in older adults.Aging Clin Exp Res. 2019 Sep;31(9):1227-1231.
  • Stangl MK, Böcker W, Chubanov V, Ferrari U, Fischereder M, Gudermann T, Hesse E, Meinke P, Reincke M, Reisch N, Saller MM, Seissler J, Schmidmaier R, Schoser B, Then C, Thorand B, Drey M. Sarcopenia - Endocrinological and Neurological Aspects. Exp Clin Endocrinol Diabetes. 2018 Sep 10
  • Drey M, Hasmann SE, Krenovsky JP, Hobert MA, Straub S, Elshehabi M, von Thaler AK, Fallgatter AJ, Eschweiler GW, Suenkel U, Berg D, Maetzler W. Associations between Early Markers of Parkinson's Disease and Sarcopenia. Front Aging Neurosci. 2017 Mar 7;9:53.
  • Landi F, Calvani R, Lorenzi M, Martone AM, Tosato M, Drey M, D'Angelo E, Capoluongo E, Russo A, Bernabei R, Onder G, Marzetti E. Serum levels of C-terminal agrin fragment (CAF) are associated with sarcopenia in older multimorbid community-dwellers: Results from the ilSIRENTE study. Exp Gerontol. 2016 Jun 15;79:31-6.
  • Drey M, Sieber CC, Bertsch T, Bauer JM, Schmidmaier R; FiAT intervention group. Osteosarcopenia is more than sarcopenia and osteopenia alone. Aging Clin Exp Res. 2015 Nov 12
  • Drey M, Krieger B, Sieber CC, Bauer JM, Hettwer S, Bertsch T; DISARCO Study Group. Motoneuron loss is associated with sarcopenia. J Am Med Dir Assoc. 2014 Jun;15(6):435-9.
  • Drey M, Grösch C, Neuwirth C, Bauer JM, Sieber CC. The Motor Unit Number Index (MUNIX) in sarcopenic patients. Exp Gerontol. 2013 Apr;48(4):381-4.
  • Drey M, Sieber CC, Bauer JM, Uter W, Dahinden P, Fariello RG, Vrijbloed JW; FiAT intervention group. C-terminal Agrin Fragment as a potential marker for sarcopenia caused by degeneration of the neuromuscular junction. Exp Gerontol. 2013 Jan;48(1):76-80.