arXiv subjects

Kenneth Rockwood

Publications and source records attributed to Kenneth Rockwood.

9 recordsLinked to original sources

arXiv2025

Inferring and predicting Fried physical frailty phenotype deficits

We predict the Fried physical frailty phenotype health deficits (FPFP5: slow gait, weakness, weight loss, low activity, and exhaustion) using two measures of frailty: frailty index (FI) or frailty phenotype (FP). The FP theorizes that the FPFP5 are mutually dependent through shared etiology and positive feedbacks, so that the total number of FPFP5 deficits (NFPFP5) should be highly predictive of existing deficits. Alternatively, the FI theorizes that strong mutual dependencies exist between \emph{all} age-related health deficits, so that the FI would be more predictive. We investigated predictive models of FPFP5 using FI or NFPFP5 in the Health and Retirement Study (HRS), the English Longitudinal Study of Aging (ELSA), and the National Health and Nutrition Examination Survey (NHANES). We find that the FI, chronological age, and current deficit state are all important predictors of future FPFP5 deficits. Notably, the FI consistently out-performed NFPFP5, raising questions regarding FPFP5 causal connections and how best to measure the physical component of frailty. We discuss implications for both FPFP5 forecasting, and inference when data are missing or incomplete.

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arXiv2024

Aging health dynamics cross a tipping point near age 75

Aging includes both continuous gradual decline, such as in physiological function, together with major deficit onset events such as morbidity, disability and ultimately death. These deficit events are stochastic and include non-linear feedbacks, making health trajectory forecasting challenging. We propose a framework for modelling the gradual effects of aging together with health deficit onset events, as reflected in the frailty index (FI) - a quantitative measure of overall age-related health. We model damage and repair dynamics of the FI from individual health transitions within two large longitudinal studies of aging health, the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), which together included N = 47592 individuals. We find that both damage resistance (robustness) and damage recovery (resilience) rates decline smoothly with both increasing age and with increasing FI, for both sexes. This leads to two distinct dynamical states: a robust and resilient young state of stable good health (low FI) and an older state that drifts towards poor health (high FI). These two health states are separated by a sharp transition near age 75. Since FI accumulation risk accelerates dramatically across this tipping point, ages 70-80 are crucial for understanding and forecasting late-life decline in health.

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arXiv2024

Systems-level health of patients living with end-stage kidney disease using standard lab values

We present a systems-level analysis of end-stage kidney disease (ESKD) with a dynamical network analysis of 14 commonly measured blood-based biomarkers in patients undergoing regular haemodialysis. Utilizing a validated pipeline for declining homeostatic systems, our approach learns a dynamical model together with an invertible transformation that simplifies the behaviour of observed biomarkers into natural variables. Within the natural variables, we identified two distinct dynamical behaviours: (i) stochastic accumulation, the random accumulation of abnormal values, and (ii) mallostasis, a deterministic drift towards worse health. These behaviours are identified by persistent fluctuations indicating weak stability, or a gradual shift in homeostatic set point, respectively. Both lead to worsening natural variable values, making the natural variables salient survival predictors with preferred directions of increasing risk. When this worsening is transformed back into observable biomarkers, it generates a coherent spectrum of worsening medical signs characteristic of a medical syndrome. Specifically, we found that small modules of natural variables corresponded to two existing syndromes commonly afflicting ESKD patients: protein-energy wasting and sepsis. We also identified new prospective syndromes. Our findings suggest that natural variables are robust, systems-level biomarkers, capturing the complex, holistic changes in health associated with ESKD.

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arXiv2022

Interpretable machine learning for high-dimensional trajectories of aging health

We have built a computational model for individual aging trajectories of health and survival, which contains physical, functional, and biological variables, and is conditioned on demographic, lifestyle, and medical background information. We combine techniques of modern machine learning with an interpretable interaction network, where health variables are coupled by explicit pair-wise interactions within a stochastic dynamical system. Our dynamic joint interpretable network (DJIN) model is scalable to large longitudinal data sets, is predictive of individual high-dimensional health trajectories and survival from baseline health states, and infers an interpretable network of directed interactions between the health variables. The network identifies plausible physiological connections between health variables as well as clusters of strongly connected health variables. We use English Longitudinal Study of Aging (ELSA) data to train our model and show that it performs better than multiple dedicated linear models for health outcomes and survival. We compare our model with flexible lower-dimensional latent-space models to explore the dimensionality required to accurately model aging health outcomes. Our DJIN model can be used to generate synthetic individuals that age realistically, to impute missing data, and to simulate future aging outcomes given arbitrary initial health states.

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arXiv2020

The potential for complex computational models of aging

The gradual accumulation of damage and dysregulation during the aging of living organisms can be quantified. Even so, the aging process is complex and has multiple interacting physiological scales -- from the molecular to cellular to whole tissues. In the face of this complexity, we can significantly advance our understanding of aging with the use of computational models that simulate realistic individual trajectories of health as well as mortality. To do so, they must be systems-level models that incorporate interactions between measurable aspects of age-associated changes. To incorporate individual variability in the aging process, models must be stochastic. To be useful they should also be predictive, and so must be fit or parameterized by data from large populations of aging individuals. In this perspective, we outline where we have been, where we are, and where we hope to go with such computational models of aging. Our focus is on data-driven systems-level models, and on their great potential in aging research.

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arXiv2018

Probing the network structure of health deficits in human aging

We confront a network model of human aging and mortality in which nodes represent health attributes that interact within a scale-free network topology, with observational data that uses both clinical and laboratory (pre-clinical) health deficits as network nodes. We find that individual health attributes exhibit a wide range of mutual information with mortality and that, with a re- construction of their relative connectivity, higher-ranked nodes are more informative. Surprisingly, we find a broad and overlapping range of mutual information of laboratory measures as compared with clinical measures. We confirm similar behavior between most-connected and least-connected model nodes, controlled by the nearest-neighbor connectivity. Furthermore, in both model and observational data, we find that the least-connected (laboratory) nodes damage earlier than the most-connected (clinical) deficits. A mean-field theory of our network model captures and explains this phenomenon, which results from the connectivity of nodes and of their connected neighbors. We find that other network topologies, including random, small-world, and assortative scale-free net- works, exhibit qualitatively different behavior. Our disassortative scale-free network model behaves consistently with our expanded phenomenology observed in human aging, and so is a useful tool to explore mechanisms of and to develop new predictive measures for human aging and mortality.

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arXiv2017

Unifying ageing and frailty through complex dynamical networks

To explore the mechanistic relationships between ageing, frailty and mortality, we developed a computational model in which possible health attributes are represented by the nodes of a complex network. Each node can be either damaged (i.e. a deficit) or undamaged. Damage of connected nodes facilitates further local damage. Our model recovers the known patterns of frailty and mortality without any programmed ageing. It helps us to understand how the observed maximum of the frailty index (FI) might arise, and allows us to start to understand how health deficits accumulate. Large model populations allow us to exploit new analytic tools, including information theory. This will allow us to systematically characterize the effects of sudden changes in the health trajectories of individuals and serve as a way to evaluate large clinical and population databases.

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arXiv2016

Network model of human aging: frailty limits and information measures

Aging is associated with the accumulation of damage throughout a persons life. Individual health can be assessed by the Frailty Index (FI). The FI is calculated simply as the proportion $f$ of accumulated age related deficits relative to the total, leading to a theoretical maximum of $f \leq 1$. Observational studies have generally reported a much more stringent bound, with $f \leq f_{max} <1$. The value of $f_{max}$ in observational studies appears to be non-universal, but $f_{max} \approx 0.7$ is often reported. A previously developed network model of individual aging was unable to recover $f_{max}<1$ while retaining the other observed phenomenology of increasing $f$ and mortality rates with age. We have developed a computationally accelerated network model that also allows us to tune the scale-free network exponent $α$. The network exponent $α$ significantly affects the growth of mortality rates with age. However, we are only able to recover $f_{max}$ by also introducing a deficit sensitivity parameter $1-q$, which is equivalent to a false-negative rate $q$. Our value of $q=0.3$ is comparable to finite sensitivities of age-related deficits with respect to mortality that are often reported in the literature. In light of non-zero $q$, we use mutual information $I$ to provide a non-parametric measure of the predictive value of the FI with respect to individual mortality. We find that $I$ is only modestly degraded by $q<1$, and this degradation is mitigated when increasing number of deficits are included in the FI. We also find that the information spectrum, i.e. the mutual information of individual deficits vs connectivity, has an approximately power-law dependence that depends on the network exponent $α$. Mutual information $I$ is therefore a useful tool for characterizing the network topology of aging populations.

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arXiv2016

A dynamical network model for age-related health deficits and mortality

How long people live depends on their health, and how it changes with age. Individual health can be tracked by the accumulation of age-related health deficits. The fraction of age-related deficits is a simple quantitative measure of human aging. This quantitative frailty index (F) is as good as chronological age in predicting mortality. In this paper, we use a dynamical network model of deficits to explore the effects of interactions between deficits, deficit damage and repair processes, and the connection between the F and mortality. With our model, we qualitatively reproduce Gompertz's law of increasing human mortality with age, the broadening of the F distribution with age, the characteristic non-linear increase of the F with age, and the increased mortality of high-frailty individuals. No explicit time-dependence in damage or repair rates is needed in our model. Instead, implicit time-dependence arises through deficit interactions -- so that the average deficit damage rates increases, and deficit repair rates decreases, with age . We use a simple mortality criterion, where mortality occurs when the most connected node is damaged.

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