与衰老过程中具有复原力表型相关的生活方式、认知和心理因素：基于人口的最年长（80 岁以上）人群的多维方法。

Lifestyle, Cognitive, and Psychological Factors Associated With a Resilience Phenotype in Aging: A Multidimensional Approach on a Population-Based Sample of Oldest-Old (80+).

机构信息

Golgi Cenci Foundation, Abbiategrasso, Milano, Italy.

Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.

出版信息

J Gerontol B Psychol Sci Soc Sci. 2024 Oct 1;79(10). doi: 10.1093/geronb/gbae132.

DOI:10.1093/geronb/gbae132

PMID:39096236

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11402365/

Abstract

OBJECTIVES

To investigate the determinants of resilience phenotype in aging, operationalized as the maintenance of cognitive, physical, and psychological health in very old individuals (80+), we investigated the structure and interrelated impact of the main resilience-enhancing factors, which are usually studied in separate research fields.

METHODS

Participants were older adults without dementia recruited for the fifth wave of the InveCe.Ab population-based cohort study (aged 83-87 years). Multidimensional evaluation comprised blood sampling, social and lifestyle survey, and geriatric and neuropsychological assessment. We classified resilient individuals as displaying normal cognition, functional independence, and mental health. First, we performed exploratory factor analysis (EFA) to examine the underlying structure of the relevant cognitive, lifestyle, physical, and psychological resilience-enhancing factors. The factors obtained were included as predictors of the resilience phenotype in the logistic regression model, controlling for sociodemographic and cumulative exposure to physical and psychosocial stressors, including COVID-19 infection.

RESULTS

Among the 404 enrolled participants, 153 (38%) exhibited the resilience phenotype. EFA resulted in the identification of six factors (59% of variance): cognitive reserve, affective reserve, insecure attachment, current lifestyle, physical reserve, and avoidant attachment. Among these factors, cognitive reserve, affective reserve, and current lifestyle significantly and independently predicted resilience status, controlling for cumulative exposure to age-related stressors and COVID-19 infection.

DISCUSSION

Our findings showed that, even in very old age, both early and late life modifiable factors affect individuals' ability to adapt to the aging process, thus confirming the importance of a life-course approach to improve health outcomes in the aged population.

CLINICAL TRIALS REGISTRATION NUMBER

NCT01345110.

摘要

目的

为了探究衰老过程中适应能力的决定因素，我们将其操作化为在非常高龄个体（80 岁以上）中保持认知、身体和心理健康。我们研究了主要的适应能力增强因素的结构和相互影响，这些因素通常在单独的研究领域中进行研究。

方法

参与者为无痴呆的老年人，他们是基于人群的 InveCe.Ab 队列研究的第五波招募对象（年龄 83-87 岁）。多维评估包括血液采样、社会和生活方式调查以及老年和神经心理学评估。我们将有适应能力的个体分为认知正常、功能独立和心理健康的个体。首先，我们进行了探索性因素分析（EFA），以检验相关认知、生活方式、身体和心理适应能力增强因素的潜在结构。获得的因素被纳入逻辑回归模型，作为适应能力表型的预测因子，同时控制社会人口统计学和累积暴露于身体和心理社会压力源，包括 COVID-19 感染。

结果

在纳入的 404 名参与者中，有 153 名（38%）表现出适应能力表型。EFA 确定了六个因素（59%的方差）：认知储备、情感储备、不安全依恋、当前生活方式、身体储备和回避依恋。在这些因素中，认知储备、情感储备和当前生活方式在控制累积暴露于与年龄相关的压力源和 COVID-19 感染后，显著且独立地预测了适应能力状态。