TY - JOUR
T1 - Dynamical indicators of resilience from physiological time series in geriatric inpatients
T2 - Lessons learned
AU - Rector, Jerrald L.
AU - Gijzel, Sanne M.W.
AU - van de Leemput, Ingrid A.
AU - van Meulen, Fokke B.
AU - Olde Rikkert, Marcel G.M.
AU - Melis, René J.F.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - The concept of physical resilience may help geriatric medicine objectively assess patients' ability to ‘bounce back’ from future health challenges. Indicators putatively forecasting resilience have been developed under two paradigms with different perspectives: Critical Slowing Down and Loss of Complexity. This study explored whether these indicators validly reflect the construct of resilience in geriatric inpatients. Geriatric patients (n = 121, 60% female) had their heart rate and physical activity continuously monitored using a chest-worn sensor. Indicators from both paradigms were extracted from both physiological signals. Measures of health functioning, concomitant with low resilience, were obtained by questionnaire at admission. The relationships among indicators and their associations with health functioning were assessed by correlation and linear regression analyses, respectively. Greater complexity and higher variance in physical activity were associated with lower frailty (β = −0.28, p = .004 and β = −0.37, p < .001, respectively) and better ADL function (β = 0.23, p = .022 and β = 0.38, p < .001). The associations of physical activity variance with health functioning were not in the expected direction based on Critical Slowing Down. In retrospect, these observations stress the importance of matching the resilience paradigm's assumptions to the homeostatic role of the variable monitored. We present several lessons learned.
AB - The concept of physical resilience may help geriatric medicine objectively assess patients' ability to ‘bounce back’ from future health challenges. Indicators putatively forecasting resilience have been developed under two paradigms with different perspectives: Critical Slowing Down and Loss of Complexity. This study explored whether these indicators validly reflect the construct of resilience in geriatric inpatients. Geriatric patients (n = 121, 60% female) had their heart rate and physical activity continuously monitored using a chest-worn sensor. Indicators from both paradigms were extracted from both physiological signals. Measures of health functioning, concomitant with low resilience, were obtained by questionnaire at admission. The relationships among indicators and their associations with health functioning were assessed by correlation and linear regression analyses, respectively. Greater complexity and higher variance in physical activity were associated with lower frailty (β = −0.28, p = .004 and β = −0.37, p < .001, respectively) and better ADL function (β = 0.23, p = .022 and β = 0.38, p < .001). The associations of physical activity variance with health functioning were not in the expected direction based on Critical Slowing Down. In retrospect, these observations stress the importance of matching the resilience paradigm's assumptions to the homeostatic role of the variable monitored. We present several lessons learned.
KW - Critical slowing down
KW - Heart rate
KW - Loss of complexity
KW - Multiscale entropy
KW - Physical activity
U2 - 10.1016/j.exger.2021.111341
DO - 10.1016/j.exger.2021.111341
M3 - Article
AN - SCOPUS:85103939552
SN - 0531-5565
VL - 149
JO - Experimental Gerontology
JF - Experimental Gerontology
M1 - 111341
ER -