Figure 1:

The conceptual organizing framework that guides measurement collection in the SPRING study. In this framework, a clinical stressor elicits a resilience response, measured by resilience phenotypes (blue box). Resilience phenotypes (Table 1) characterize both the initial response to the stressor, and the recovery or decline thereafter, in key markers of physical and cognitive function and health. These therefore are “trajectories” of key measures, beginning shortly before the stressor experience and continuing afterward up until a timeframe at which we may expect a resilient person to recover their pre-stressor status—operationalized in this study as one year. We hypothesize that physiologic resilience capacity is influenced by static baseline measures (white box) and can be elicited by measures assessing the functionality of specific dynamical systems that are measured before the stressor (left orange box). We also hypothesize that physical frailty and a measure of fatigue can function as surrogate measures of resilience capacity (right orange box). Both the resilience capacity and phenotypes potentially contribute to clinical outcomes (gray box).