ABSTRACT: As people age, the ability to cope with and recover from health challenges becomes important for maintaining independence and quality of life. The central goal of resilience research is not only to predict who may struggle when facing life’s challenges, but—more importantly—to strengthen resilience early, helping individuals bounce back and remain independent. This talk will review the concept and measurement of resilience, with a focus on physical resilience. Statistical approaches for defining resilience phenotypes will be discussed, particularly latent variable models that capture multivariate physical resilience based on individual recovery dynamics before and after a physical stressor such as surgery. Drawing on data from a prospective observational study of 104 adults aged 60 and older who underwent elective total knee replacement (TKR), the presentation will highlight findings from a hybrid latent profile and latent class analysis that identified distinct recovery trajectories. The talk will also explore how these trajectories relate to clinical and patient-reported outcomes 12 months after TKR. Finally, a decision curve analysis will be presented to evaluate whether physical function trajectories outperform baseline measures in guiding post-TKR rehabilitation decisions—compared to strategies that treat all patients or none. Together, these findings aim to advance how we assess, predict, and ultimately support physical resilience in older adults facing clinical stressors.
SHORT BIO: Dr. Xue is an Associate Professor of Medicine in Geriatric Medicine and Gerontology and a founding core member of the Johns Hopkins Center on Aging and Health (COAH), with joint appointments in Biostatistics and Epidemiology at the Johns Hopkins Bloomberg School of Public Health. He co-founded the COAH Biostatistics Group, which has been instrumental in establishing and renewing both the Johns Hopkins Older Americans Independence Center (OAIC) and the Alzheimer’s Disease Resource Center for Minority Aging Research (AD-RCMAR). As an independent researcher and a biostatistical collaborator, Dr. Xue has made significant contributions to the development and validation of aging phenotypes such as frailty and sarcopenia. His research has advanced understanding of the heterogeneity of frailty, clarifying its diverse etiologies and outcomes, and laying critical groundwork for clinical translation. This includes ongoing initiatives to integrate frailty screening into the Program for All-Inclusive Care for the Elderly and collaborative efforts to implement the age-friendly hospital measure in geriatric surgery. Dr. Xue’s scholarly impact is reflected in his extensive publication record, which includes 224 peer-reviewed articles, and recognition through honors such as the Nathan Shock Scholar Award and fellowship in the Gerontological Society of America. He also serves as Associate Editor for the Journals of Gerontology: Medical Sciences. He is also deeply committed to mentorship and education, guiding Master’s and Ph.D. students, as well as postdoctoral fellows in Epidemiology, Geriatrics, and Gerontology. As leader of the OAIC Biostatistics Core and the AD-RCMAR Analysis Core, Dr. Xue has mentored numerous trainees, including 15 junior faculty members from Schools of Medicine, Public Health, and Nursing.
