Avelino-Silva Thiago J, Moini Niousha
Division of Geriatrics, School of Medicine, University of California, San Francisco, California, USA.
Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
J Am Geriatr Soc. 2025 Jun 3. doi: 10.1111/jgs.19566.
Resilience is increasingly recognized as a central factor in how older adults adapt to life's inevitable changes, yet many clinicians remain unfamiliar with its practical applications in late life. Drawing on the true story of Cocota, a Brazilian matriarch who lived to be 100, this special article illustrates how resilience is neither a static trait nor limited to mere survival. Instead, it emerges over decades, shaped by early adversities and sustained through purposeful roles, strong social ties, and an enduring sense of autonomy. Although psychological, social, and spiritual resources are crucial, physiological resilience also plays an essential role, reflecting adaptive responses at organ, cellular, and molecular levels that help older adults recover from acute health stressors. In Cocota's case, a hip fracture in her 80s did not lead to permanent disability; rather, she reclaimed her daily routines, demonstrating the interplay between physical robustness and unwavering determination. Equally telling was her decision to "stop eating and drinking" near life's end, exemplifying resilience as a final expression of agency. We further explore how her experiences align with deeper forms of well-being, marked by purpose and prosocial behavior, and practical wisdom, including emotional regulation and sound moral judgment. By examining her life journey, clinicians and community partners can better appreciate how resilience spans physical, cognitive, psychosocial, and spiritual domains, ultimately guiding more integrated strategies to support older adults. The lessons learned have direct relevance for clinical interventions, community programs, and public health initiatives aimed at fostering autonomy and meaningful engagement in later life.
复原力越来越被视为老年人如何适应生活中不可避免变化的核心因素，但许多临床医生仍不熟悉其在晚年的实际应用。本文以活到100岁的巴西女家长科科塔的真实故事为例，阐述了复原力既不是一种静态特质，也不限于仅仅生存下去。相反，它是在几十年间形成的，受早年逆境的影响，并通过有意义的角色、牢固的社会关系和持久的自主意识得以维持。尽管心理、社会和精神资源至关重要，但生理复原力也起着关键作用，反映了器官、细胞和分子层面的适应性反应，有助于老年人从急性健康压力源中恢复过来。以科科塔为例，她80多岁时髋部骨折并未导致永久性残疾；相反，她恢复了日常生活，展示了身体强健与坚定决心之间的相互作用。同样值得注意的是，她在生命接近尾声时决定“停止饮食”，这体现了复原力是能动性的最终表现。我们进一步探讨她的经历如何与更深层次的幸福感相契合，这种幸福感以目标感和亲社会行为为特征，以及与实用智慧相契合，包括情绪调节和合理的道德判断。通过审视她的人生旅程，临床医生和社区合作伙伴能够更好地理解复原力如何跨越身体、认知、心理社会和精神领域，最终指导制定更综合的策略来支持老年人。所汲取的经验教训与旨在促进晚年自主性和有意义参与度 的临床干预、社区项目及公共卫生倡议直接相关。
