OBJECTIVES Acute illnesses and subsequent hospital admissions present large health stressors to older adults, after which their recovery is variable. The concept of physical resilience offers opportunities to develop dynamical tools to predict an individual's recovery potential. This study aimed to investigate if dynamical resilience indicators based on repeated physical and mental measurements in acutely hospitalized geriatric patients have added value over single baseline measurements in predicting favorable recovery. DESIGN Intensive longitudinal study. SETTING AND PARTICIPANTS 121 patients (aged 84.3 ± 6.2 years, 60% female) admitted to the geriatric ward for acute illness. MEASUREMENTS In addition to preadmission characteristics (frailty, multimorbidity), in-hospital heart rate and physical activity were continuously monitored with a wearable sensor. Momentary well-being (life satisfaction, anxiety, discomfort) was measured by experience sampling 4 times per day. The added value of dynamical indicators of resilience was investigated for predicting recovery at hospital discharge and 3 months later. RESULTS 31% of participants satisfied the criteria of good recovery at hospital discharge and 50% after 3 months. A combination of a frailty index, multimorbidity, Clinical Frailty Scale, and or gait speed predicted good recovery reasonably well on the short term [area under the receiver operating characteristic curve (AUC) = 0.79], but only moderately after 3 months (AUC = 0.70). On addition of dynamical resilience indicators, the AUC for predicting good 3-month recovery increased to 0.79 (P = .03). Variability in life satisfaction and anxiety during the hospital stay were independent predictors of good 3-month recovery [odds ratio (OR) = 0.24, P = .01, and OR = 0.54, P = .04, respectively]. CONCLUSIONS AND IMPLICATIONS These results highlight that measurements capturing the dynamic functioning of multiple physiological systems have added value in assessing physical resilience in clinical practice, especially those monitoring mental responses. Improved monitoring and prediction of physical resilience could help target intensive treatment options and subsequent geriatric rehabilitation to patients who will most likely benefit from them.

中文翻译：

---

动态弹性指标的测量提高了老年人住院后康复的预测

目标 急性疾病和随后的住院会给老年人带来巨大的健康压力，之后他们的康复情况各不相同。身体恢复力的概念为开发动态工具以预测个人的恢复潜力提供了机会。本研究旨在调查基于急性住院老年患者的重复身心测量的动态弹性指标是否比单一基线测量在预测良好恢复方面具有附加值。设计 密集的纵向研究。设置和参与者 121 名患者（年龄 84.3 ± 6.2 岁，60% 为女性）因急性疾病入住老年病房。测量 除了入院前的特征（虚弱、多发病），使用可穿戴传感器持续监测院内心率和身体活动。暂时的幸福感（生活满意度、焦虑、不适）通过每天 4 次的经验抽样来衡量。研究了弹性动态指标的附加值，用于预测出院时和 3 个月后的恢复。结果 31% 的参与者满足出院时恢复良好的标准，3 个月后满足 50% 的标准。虚弱指数、多发病率、临床虚弱量表和/或步态速度的组合在短期内相当好地预测了良好的恢复 [受试者工作特征曲线下面积 (AUC) = 0.79]，但仅在 3 个月后适度恢复 (AUC = 0.70）。添加动态弹性指标后，预测 3 个月良好恢复的 AUC 增加至 0.79 (P = .03)。住院期间生活满意度和焦虑的变化是 3 个月恢复良好的独立预测因素 [优势比 (OR) = 0.24，P = .01 和 OR = 0.54，P = .04，分别]。结论和意义这些结果强调，捕捉多个生理系统动态功能的测量在评估临床实践中的身体弹性方面具有附加价值，尤其是那些监测心理反应的。改善对身体恢复能力的监测和预测有助于针对最有可能从中受益的患者提供强化治疗方案和随后的老年康复治疗。结论和意义这些结果强调，捕捉多个生理系统动态功能的测量在评估临床实践中的身体弹性方面具有附加价值，尤其是那些监测心理反应的。改善对身体恢复能力的监测和预测有助于针对最有可能从中受益的患者提供强化治疗方案和随后的老年康复治疗。结论和意义这些结果强调，捕捉多个生理系统动态功能的测量在评估临床实践中的身体弹性方面具有附加价值，尤其是那些监测心理反应的。改善对身体恢复能力的监测和预测有助于针对最有可能从中受益的患者提供强化治疗方案和随后的老年康复治疗。