Department of Medicine, Duke University Claude D. Pepper Older Americans Independence Center, Center for Aging, Duke University, Durham, North Carolina, USA.
Geriatric Research Education Clinical Center, Durham Veteran Affairs Health Care System, Durham, North Carolina, USA.
Stress Health. 2023 Sep;39(S1):48-54. doi: 10.1002/smi.3241. Epub 2023 Mar 15.
The objectives of this article are to introduce a conceptual framework for physical resilience in the context of ageing and to discuss key elements and challenges in the design of studies of physical resilience after health stressors. Advancing age is associated with increasing exposure to multiple stressors and declining capacity to respond to health stressors. Resilience is defined broadly as the ability to resist or recover well from the adverse effects of a health stressor. In ageing-related study designs of physical resilience after a health stressor, this dynamic resilience response can be observed as changes in repeated measures of function or health status in various domains important to older adults. Methodologic issues in selecting the study population, defining the stressor, covariates, outcomes, and analytic strategies are highlighted in the context of an ongoing prospective cohort study of physical resilience after total knee replacement surgery. The article concludes with approaches to intervention development to optimize resilience.
本文旨在介绍老龄化背景下身体复原力的概念框架，并讨论健康压力源后身体复原力研究设计中的关键要素和挑战。随着年龄的增长，人们会接触到越来越多的压力源，同时应对健康压力源的能力也会下降。复原力被广泛定义为抵抗或从健康压力源的不利影响中恢复的能力。在与年龄相关的健康压力源后身体复原力的研究设计中，可以通过观察功能或健康状况在老年人重要领域的重复测量的变化来观察这种动态的复原力反应。本文以正在进行的全膝关节置换术后身体复原力的前瞻性队列研究为例，重点讨论了在选择研究人群、定义压力源、协变量、结局和分析策略方面的方法学问题。文章最后介绍了优化复原力的干预措施的开发方法。
