Qian-Li Xue, Thomas Laskow, Mallak K Alzahrani, Ravi Varadhan, Jeremy D Walston, Jennifer A Schrack, Anne B Newman, Frederick Sieber, Karen Bandeen-Roche
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A multivariate resilience phenotype was derived from physical function assessments over 12 months after TKR using the Short Physical Performance Battery, the Pittsburgh Fatigability Scale Physical Subscale, the Knee Injury and Osteoarthritis Outcome Quality of Life Score, and the 36-Item Short Form Health Survey Physical Component Score. Validation was performed using markers (i.e., frailty and self-reported health) and determinants (e.g., the Charlson Comorbidity Index (CCI)) of recovery potential. Results Distinct resilience profiles were identified across the four measures, showing varied baseline levels and/or change rates over 12 months. By combining and analyzing resilience profiles across measures, two distinct groups emerged: 33.7% were classified as non-resilient and 66.4% as resilient. The non-resilient group had a higher prevalence of frailty (37.1% vs. 10.1%, p<0.01), poor or fair self-reported health (48.6% vs. 5.8%, p<0.01), and moderate or severe comorbidity burden (CCI >2; 28.6% vs. 10.1%, p=0.03). Conclusions Recovery trajectories after TKR revealed varying resilience levels that could not be fully explained by baseline health status. Understanding individual resilience can enhance patient care by promoting recovery and overall well-being.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"17 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multivariate Profiling of Physical Resilience in Older Adults After Total Knee Replacement Surgery: Results from a Prospective Observational Study\",\"authors\":\"Qian-Li Xue, Thomas Laskow, Mallak K Alzahrani, Ravi Varadhan, Jeremy D Walston, Jennifer A Schrack, Anne B Newman, Frederick Sieber, Karen Bandeen-Roche\",\"doi\":\"10.1093/gerona/glaf032\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background As individuals age, their ability to cope with and recovering from health challenges becomes vital for maintaining independence and quality of life. This study aims to develop a multivariate phenotype of physical resilience based on individual recovery dynamics before and after a physical stressor. Methods This prospective observational study included 104 individuals aged ≥ 60 who underwent elective total knee replacement (TKR) for degenerative joint disease between December 2, 2019, and January 4, 2023. A multivariate resilience phenotype was derived from physical function assessments over 12 months after TKR using the Short Physical Performance Battery, the Pittsburgh Fatigability Scale Physical Subscale, the Knee Injury and Osteoarthritis Outcome Quality of Life Score, and the 36-Item Short Form Health Survey Physical Component Score. Validation was performed using markers (i.e., frailty and self-reported health) and determinants (e.g., the Charlson Comorbidity Index (CCI)) of recovery potential. Results Distinct resilience profiles were identified across the four measures, showing varied baseline levels and/or change rates over 12 months. By combining and analyzing resilience profiles across measures, two distinct groups emerged: 33.7% were classified as non-resilient and 66.4% as resilient. The non-resilient group had a higher prevalence of frailty (37.1% vs. 10.1%, p<0.01), poor or fair self-reported health (48.6% vs. 5.8%, p<0.01), and moderate or severe comorbidity burden (CCI >2; 28.6% vs. 10.1%, p=0.03). Conclusions Recovery trajectories after TKR revealed varying resilience levels that could not be fully explained by baseline health status. 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引用次数: 0
摘要
随着个人年龄的增长,他们应对和从健康挑战中恢复的能力对于保持独立性和生活质量至关重要。本研究旨在建立一个基于个体在生理应激前后恢复动态的多变量生理弹性表型。该前瞻性观察研究纳入了104名年龄≥60岁的患者,他们在2019年12月2日至2023年1月4日期间因退行性关节疾病接受了选择性全膝关节置换术(TKR)。在TKR后的12个月内,使用短物理性能电池、匹兹堡疲劳量表物理子量表、膝关节损伤和骨关节炎结局生活质量评分以及36项简短健康调查物理成分评分对身体功能进行评估,得出多变量弹性表型。使用恢复潜力的标记(即虚弱和自我报告的健康状况)和决定因素(例如Charlson共病指数(CCI))进行验证。结果在四种测量方法中发现了不同的恢复能力概况,显示出12个月内不同的基线水平和/或变化率。通过组合和分析不同措施的弹性概况,出现了两个不同的群体:33.7%被归类为无弹性,66.4%被归类为有弹性。非弹性组有更高的患病率虚弱(37.1%对10.1%,p<0.01),不良或一般的自我报告健康(48.6%对5.8%,p<0.01)和中度或重度共病负担(CCI < 2;28.6% vs. 10.1%, p=0.03)。结论TKR后的恢复轨迹显示了不同的恢复力水平,这不能完全用基线健康状况来解释。了解个体的复原力可以通过促进康复和整体健康来提高病人的护理水平。
Multivariate Profiling of Physical Resilience in Older Adults After Total Knee Replacement Surgery: Results from a Prospective Observational Study
Background As individuals age, their ability to cope with and recovering from health challenges becomes vital for maintaining independence and quality of life. This study aims to develop a multivariate phenotype of physical resilience based on individual recovery dynamics before and after a physical stressor. Methods This prospective observational study included 104 individuals aged ≥ 60 who underwent elective total knee replacement (TKR) for degenerative joint disease between December 2, 2019, and January 4, 2023. A multivariate resilience phenotype was derived from physical function assessments over 12 months after TKR using the Short Physical Performance Battery, the Pittsburgh Fatigability Scale Physical Subscale, the Knee Injury and Osteoarthritis Outcome Quality of Life Score, and the 36-Item Short Form Health Survey Physical Component Score. Validation was performed using markers (i.e., frailty and self-reported health) and determinants (e.g., the Charlson Comorbidity Index (CCI)) of recovery potential. Results Distinct resilience profiles were identified across the four measures, showing varied baseline levels and/or change rates over 12 months. By combining and analyzing resilience profiles across measures, two distinct groups emerged: 33.7% were classified as non-resilient and 66.4% as resilient. The non-resilient group had a higher prevalence of frailty (37.1% vs. 10.1%, p<0.01), poor or fair self-reported health (48.6% vs. 5.8%, p<0.01), and moderate or severe comorbidity burden (CCI >2; 28.6% vs. 10.1%, p=0.03). Conclusions Recovery trajectories after TKR revealed varying resilience levels that could not be fully explained by baseline health status. Understanding individual resilience can enhance patient care by promoting recovery and overall well-being.