University of Twente Student Theses
Quantification of Physical Resilience in Older Adults Using Continuous Blood Pressure Signals
Vulders, Lisa (2022) Quantification of Physical Resilience in Older Adults Using Continuous Blood Pressure Signals.
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| Abstract: | Background: Resilience is defined as a person’s ability to bounce back after a stressor. In geriatric medicine, quantifying resilience could be of added value to support clinical decision making. Blood pressure (BP) recovery, measured using volume-clamp photoplethysmography after an orthostatic challenge, is known to associate with different outcomes related to resilience. Many data points obtained from the BP signal are normally ignored during analysis. Waveform morphology could provide patient-specific information about cardiac function and arterial stiffness. Grip work is another concept that is known to associate with frailty. The aim of this study was (1) to address the feasibility and added value of quantification of resilience in clinical practice and (2) to investigate the analysis of waveform morphologies in continuous BP signals. Methods: (1) Patients visiting the pre-operative outpatient geriatric clinic were included. They performed a supine-to-stand test and a grip work measurement. BP recovery values, initial drop in BP, grip strength and grip work were tested for associations with cross-sectional outcome measures targeting frailty. Feasibility of the measurements in clinical practice was assessed by interviewing geriatricians and collecting experiences. (2) Analysis of continuous BP signals of 52 participants with Alzheimer’s disease was performed. Waveform morphology was quantified using three waveform characteristics. Change in morphology caused by orthostatic stress was evaluated, as well as relation with cognitive decline. Results: (1) 39 patients were included in our study, of which continuous BP data was recorded in thirty patients. BP values did not associate with our outcome measures. Grip work was significantly associated with all outcome measures and showed stronger associations than only grip strength. Measurements have shown to be feasible in clinical practice, taking into account a few practical and technical improvements. (2) We showed that waveform characteristics change significantly after exposure to orthostatic stress. No association with cognitive decline was found. Conclusion: We showed that quantitative resilience measures are feasible to implement at the geriatric outpatient clinic. The possible association of BP recovery with resilience is believed to be counter affected by long transition times from supine to stand in more frail patients. Re-analysis of BP values and grip work should be done with more inclusions and longer follow-up periods including post-operative outcomes. The analysis of waveform morphology in the scope of cognitive decline and resilience did not lead to new insights, but could be valuable targeting cardiovascular function since we prove that quantified morphology changes upon orthostatic stress. |
| Item Type: | Essay (Master) |
| Clients: | Radboudumc, Nijmegen, Nederland |
| Faculty: | TNW: Science and Technology |
| Subject: | 42 biology, 44 medicine, 50 technical science in general |
| Programme: | Technical Medicine MSc (60033) |
| Link to this item: | https://purl.utwente.nl/essays/89415 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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