Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
Duke Global Health Institute, Duke University, Durham, North Carolina.
J Gerontol A Biol Sci Med Sci. 2020 Sep 25;75(10):1960-1966. doi: 10.1093/gerona/glz247.
The concept of resilience has gained increasing attention in aging research; however, current literature lacks consensus on how to measure resilience. We constructed a novel resilience measure based on the degree of mismatch between persons' frailty level and disease burden and examined its predictive validity. We also sought to explore the physiological correlates of resilience.
Participants were 2,457 older adults from the Health, Aging, and Body Composition Study. We constructed the resilience measure as the residual taken from the linear model regressing frailty on age, sex, race/ethnicity, 14 diseases, self-reported health, and number of medications. Participants were classified into three groups-adapters, expected agers, and premature frailers-based on residuals (less than, within, or above one standard deviation of the mean). Validation outcomes included years of able life (YAL), years of healthy life (YHL), years of healthy and able life (YHAL), disability, hospitalization, and survival.
The average YHAL was 5.1, 7.7, and 9.1 years among premature frailers, expected agers, and adapters, respectively. Compared with premature frailers and expected agers, adapters had significantly lower rates of disability, hospitalization, and mortality and higher proportion surviving to 90 years. The likelihood of surviving to 90 years was 20.4%, 30.6%, and 39.7% among premature frailers, expected agers, and adapters.
We developed and validated a novel approach for quantifying and classifying physical resilience in a cohort of well-functioning white and black older adults. Persons with high physical resilience level had longer healthy life span and lower rates of adverse outcomes.
适应力的概念在衰老研究中受到越来越多的关注；然而，目前的文献缺乏衡量适应力的共识。我们构建了一种新的适应力衡量标准，基于个体脆弱程度和疾病负担之间的不匹配程度，并检验了其预测效度。我们还试图探索适应力的生理相关性。
参与者为来自健康、衰老和身体成分研究的 2457 名老年人。我们构建了适应力衡量标准，作为将脆弱性与年龄、性别、种族/民族、14 种疾病、自我报告的健康状况和用药数量进行线性回归的残差。参与者根据残差（小于、等于或大于平均值一个标准差）分为三组——适应者、预期衰老者和过早脆弱者。验证结果包括能够生活的年数（YAL）、健康生活的年数（YHL）、健康和能够生活的年数（YHAL）、残疾、住院和生存。
过早脆弱者、预期衰老者和适应者的平均 YHAL 分别为 5.1、7.7 和 9.1 年。与过早脆弱者和预期衰老者相比，适应者的残疾、住院和死亡率较低，且存活至 90 岁的比例较高。过早脆弱者、预期衰老者和适应者存活至 90 岁的可能性分别为 20.4%、30.6%和 39.7%。
我们开发并验证了一种在功能良好的白人和黑人老年人队列中量化和分类身体适应力的新方法。身体适应力水平高的人健康寿命更长，不良结局的发生率更低。
