Skip to main content
Journal cover image

A template for physical resilience research in older adults: Methods of the PRIME-KNEE study.

Publication ,  Journal Article
Whitson, HE; Crabtree, D; Pieper, CF; Ha, C; Au, S; Berger, M; Cohen, HJ; Feld, J; Smith, P; Hall, K; Parker, D; Kraus, VB; Kraus, WE ...
Published in: J Am Geriatr Soc
November 2021

BACKGROUND: Older adults with similar health conditions often experience widely divergent outcomes following health stressors. Variable recovery after a health stressor may be due in part to differences in biological mechanisms at the molecular, cellular, or system level, that are elicited in response to stressors. We describe the PRIME-KNEE study as an example of ongoing research to validate provocative clinical tests and biomarkers that predict resilience to specific health stressors. METHODS: PRIME-KNEE is an ongoing, prospective cohort study that will enroll 250 adults ≥60 years undergoing total knee arthroplasty. Data are collected at baseline (pre-surgery), during surgery, daily for 7 days after surgery, and at 1, 2, 4, and 6 months post-surgery. Provocative tests include a cognition-motor dual-task walking test, cerebrovascular reactivity assessed by functional near-infrared spectroscopy, peripheral blood mononuclear cell reactivity ex vivo to lipopolysaccharide toxin and influenza vaccine, and heart rate variability during surgery. Cognitive, psychological, and physical performance batteries are collected at baseline to estimate prestressor reserve. Demographics, medications, comorbidities, and stressor characteristics are abstracted from the electronic medical record and via participant interview. Blood-based biomarkers are collected at baseline and postoperative day 1. Repeated measures after surgery include items from a delirium assessment tool and pain scales administered daily by telephone for 7 days and cognitive change index (participant and informant), lower extremity activities of daily living, pain scales, and step counts assessed by Garmin actigraphy at 1, 2, 4, and 6 months after surgery. Statistical models use these measures to characterize resilience phenotypes and evaluate prestressor clinical indicators associated with poststressor resilience. CONCLUSION: If PRIME-KNEE validates feasible clinical tests and biomarkers that predict recovery trajectories in older surgical patients, these tools may inform surgical decision-making, guide pre-habilitation efforts, and elucidate mechanisms underlying resilience. This study design could motivate future geriatric research on resilience.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

November 2021

Volume

69

Issue

11

Start / End Page

3232 / 3241

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Stress, Psychological
  • Spectroscopy, Near-Infrared
  • Resilience, Psychological
  • Prospective Studies
  • Postoperative Period
  • Pain Measurement
  • Middle Aged
  • Male
  • Longitudinal Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Whitson, H. E., Crabtree, D., Pieper, C. F., Ha, C., Au, S., Berger, M., … Colón-Emeric, C. (2021). A template for physical resilience research in older adults: Methods of the PRIME-KNEE study. J Am Geriatr Soc, 69(11), 3232–3241. https://doi.org/10.1111/jgs.17384
Whitson, Heather E., Donna Crabtree, Carl F. Pieper, Christine Ha, Sandra Au, Miles Berger, Harvey J. Cohen, et al. “A template for physical resilience research in older adults: Methods of the PRIME-KNEE study.J Am Geriatr Soc 69, no. 11 (November 2021): 3232–41. https://doi.org/10.1111/jgs.17384.
Whitson HE, Crabtree D, Pieper CF, Ha C, Au S, Berger M, et al. A template for physical resilience research in older adults: Methods of the PRIME-KNEE study. J Am Geriatr Soc. 2021 Nov;69(11):3232–41.
Whitson, Heather E., et al. “A template for physical resilience research in older adults: Methods of the PRIME-KNEE study.J Am Geriatr Soc, vol. 69, no. 11, Nov. 2021, pp. 3232–41. Pubmed, doi:10.1111/jgs.17384.
Whitson HE, Crabtree D, Pieper CF, Ha C, Au S, Berger M, Cohen HJ, Feld J, Smith P, Hall K, Parker D, Kraus VB, Kraus WE, Schmader K, Colón-Emeric C. A template for physical resilience research in older adults: Methods of the PRIME-KNEE study. J Am Geriatr Soc. 2021 Nov;69(11):3232–3241.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

November 2021

Volume

69

Issue

11

Start / End Page

3232 / 3241

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Stress, Psychological
  • Spectroscopy, Near-Infrared
  • Resilience, Psychological
  • Prospective Studies
  • Postoperative Period
  • Pain Measurement
  • Middle Aged
  • Male
  • Longitudinal Studies