We all know older friends or family members who find themselves in need of a serious medical procedure. For some, it’s a hip replacement. For others, it’s cardiac surgery or a cancer-related treatment.
Most sail through these procedures and make a quick and resilient recovery. For others, recovery is slow and they don’t bounce back. Sometimes a cascade of complications follows.
Why are some older people more resilient than others? That’s the question that geriatrician Jeremy Walston, the Raymond and Anna Lublin Professor of Geriatric Medicine, and his team at Johns Hopkins Bayview Medical Center have set out to explore, under a new five-year $11.5 million grant from the National Institutes of Health (NIH).
“This grant will allow us to identify the biological underpinnings of resilience, which we believe are related to the stress response systems in the body,” explains Walston, who co-directs the Biology of Healthy Aging program at Bayview. “Someone who is resilient is more likely to have more stable and less easily broken down stress responses during a stressful period.”
Walston and his team will soon be recruiting older patients who are undergoing one of three medical procedures: hip replacement, hemodialysis (for chronic kidney disease) or bone marrow transplant (for hematological cancer).
“Some of these patients will do very well, while others will suffer many complications. We aim to study both groups and identify subsets of biological differences between them,” says Walston.
If the researchers can identify biological markers for resiliency, doctors will be able to figure out in advance which patients might be more susceptible to complications – and take preventive measures to ward off those problems.
If the researchers can identify biological markers for resiliency, doctors will be able to figure out in advance which patients might be more susceptible to complications – and take preventive measures to ward off those problems.
Walston believes that an overactive inflammatory system may be involved. “If we do find the inflammatory system is over-responsive in those who are less resilient, we could potentially develop methods to modify that response in susceptible patients before they undergo the medical procedure,” he says.
He is in fact already working toward that goal of developing a suitable treatment for chronic inflammation – thanks in part through funding from philanthropist Charles H. Salisbury, Jr., a Center for Innovative Medicine International Advisory Board Member, and his wife Bunny Salisbury (see sidebar).
Ultimately, identifying the biological underpinnings of resilience could have a dramatic impact on improving the quality of life for all older people. The long-term goal, says Walston, is to keep these stress response systems intact and operating normally as we age. “Through this research, we hope to help people live longer, healthier lives – and to help them bounce back quickly if and when a medical problem does crop up.”
