Udeh-Momoh Chinedu T, Migeot Joaquin, Blackmon Karen, Mielke Michelle M, Melloni Margherita, Cox Lynne, Yaffe Kristine, Santamaria-Garcia Hernando, Stern Yaakov, Ibanez Agustin
Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.
Nat Med. 2025 Jul 29. doi: 10.1038/s41591-025-03846-w.
Resilience is a multifaceted concept that spans biological, psychological and social domains, and is critical for population health-particularly brain health. While most existing research originates from the global north, there is an urgent need to explore resilience in the majority world settings, where unique biological, exposomal, economic and sociocultural factors shape health. In this Review, we highlight resilience as a key modifier of brain health outcomes. We explore the biological correlates of resilience and the influence of the exposome. We propose future synergistic integrations of exposome, cultural reserve, community resilience, allostasis and whole-body health principles to promote an inclusive perspective in diverse settings. This approach is particularly relevant for majority world contexts, where resource constraints and cultural diversity demand adaptive, scalable and context-sensitive strategies. We discuss measurement approaches and operationalization strategies and, finally, we identify key priorities for future research and policy strategies, with an emphasis on local relevance, equity and sustainability.
复原力是一个多方面的概念，涵盖生物、心理和社会领域，对人群健康尤其是大脑健康至关重要。虽然大多数现有研究来自全球北方，但迫切需要在多数世界背景下探索复原力，在这些背景中，独特的生物、暴露组、经济和社会文化因素塑造着健康。在本综述中，我们强调复原力是大脑健康结果的关键调节因素。我们探讨复原力的生物学关联以及暴露组的影响。我们提出未来暴露组、文化储备、社区复原力、异稳态和全身健康原则的协同整合，以在不同背景下促进包容性观点。这种方法在多数世界背景下尤为相关，因为资源限制和文化多样性需要适应性、可扩展且因地制宜的策略。我们讨论测量方法和实施策略，最后，我们确定未来研究和政策策略的关键优先事项，重点是与当地的相关性、公平性和可持续性。
