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Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults

BACKGROUND: Geriatricians are often confronted with unexpected health outcomes in older adults with complex multimorbidity. Aging researchers have recently called for a focus on physical resilience as a new approach to explaining such outcomes. Physical resilience, defined as the ability to resist f...

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Autores principales: Gijzel, Sanne M. W., Whitson, Heather E., van de Leemput, Ingrid A., Scheffer, Marten, van Asselt, Dieneke, Rector, Jerrald L., Olde Rikkert, Marcel G. M., Melis, René J. F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916426/
https://www.ncbi.nlm.nih.gov/pubmed/31498881
http://dx.doi.org/10.1111/jgs.16149
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author Gijzel, Sanne M. W.
Whitson, Heather E.
van de Leemput, Ingrid A.
Scheffer, Marten
van Asselt, Dieneke
Rector, Jerrald L.
Olde Rikkert, Marcel G. M.
Melis, René J. F.
author_facet Gijzel, Sanne M. W.
Whitson, Heather E.
van de Leemput, Ingrid A.
Scheffer, Marten
van Asselt, Dieneke
Rector, Jerrald L.
Olde Rikkert, Marcel G. M.
Melis, René J. F.
author_sort Gijzel, Sanne M. W.
collection PubMed
description BACKGROUND: Geriatricians are often confronted with unexpected health outcomes in older adults with complex multimorbidity. Aging researchers have recently called for a focus on physical resilience as a new approach to explaining such outcomes. Physical resilience, defined as the ability to resist functional decline or recover health following a stressor, is an emerging construct. METHODS: Based on an outline of the state‐of‐the‐art in research on the measurement of physical resilience, this article describes what tests to predict resilience can already be used in clinical practice and which innovations are to be expected soon. RESULTS: An older adult's recovery potential is currently predicted by static tests of physiological reserves. Although geriatric medicine typically adopts a multidisciplinary view of the patient and implicitly performs resilience management to a certain extent, clinical management of older adults can benefit from explicitly applying the dynamical concept of resilience. Two crucial leads for advancing our capacity to measure and manage the resilience of individual patients are advocated: first, performing multiple repeated measurements around a stressor can provide insight about the patient's dynamic responses to stressors; and, second, linking psychological and physiological subsystems, as proposed by network studies on resilience, can provide insight into dynamic interactions involved in a resilient response. CONCLUSION: A big challenge still lies ahead in translating the dynamical concept of resilience into clinical tools and guidelines. As a first step in bridging this gap, this article outlines what opportunities clinicians and researchers can already exploit to improve prediction, understanding, and management of resilience of older adults. J Am Geriatr Soc 67:2650–2657, 2019
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spelling pubmed-69164262019-12-23 Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults Gijzel, Sanne M. W. Whitson, Heather E. van de Leemput, Ingrid A. Scheffer, Marten van Asselt, Dieneke Rector, Jerrald L. Olde Rikkert, Marcel G. M. Melis, René J. F. J Am Geriatr Soc Review Articles BACKGROUND: Geriatricians are often confronted with unexpected health outcomes in older adults with complex multimorbidity. Aging researchers have recently called for a focus on physical resilience as a new approach to explaining such outcomes. Physical resilience, defined as the ability to resist functional decline or recover health following a stressor, is an emerging construct. METHODS: Based on an outline of the state‐of‐the‐art in research on the measurement of physical resilience, this article describes what tests to predict resilience can already be used in clinical practice and which innovations are to be expected soon. RESULTS: An older adult's recovery potential is currently predicted by static tests of physiological reserves. Although geriatric medicine typically adopts a multidisciplinary view of the patient and implicitly performs resilience management to a certain extent, clinical management of older adults can benefit from explicitly applying the dynamical concept of resilience. Two crucial leads for advancing our capacity to measure and manage the resilience of individual patients are advocated: first, performing multiple repeated measurements around a stressor can provide insight about the patient's dynamic responses to stressors; and, second, linking psychological and physiological subsystems, as proposed by network studies on resilience, can provide insight into dynamic interactions involved in a resilient response. CONCLUSION: A big challenge still lies ahead in translating the dynamical concept of resilience into clinical tools and guidelines. As a first step in bridging this gap, this article outlines what opportunities clinicians and researchers can already exploit to improve prediction, understanding, and management of resilience of older adults. J Am Geriatr Soc 67:2650–2657, 2019 John Wiley & Sons, Inc. 2019-09-09 2019-12 /pmc/articles/PMC6916426/ /pubmed/31498881 http://dx.doi.org/10.1111/jgs.16149 Text en © 2019 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Review Articles
Gijzel, Sanne M. W.
Whitson, Heather E.
van de Leemput, Ingrid A.
Scheffer, Marten
van Asselt, Dieneke
Rector, Jerrald L.
Olde Rikkert, Marcel G. M.
Melis, René J. F.
Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults
title Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults
title_full Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults
title_fullStr Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults
title_full_unstemmed Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults
title_short Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults
title_sort resilience in clinical care: getting a grip on the recovery potential of older adults
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916426/
https://www.ncbi.nlm.nih.gov/pubmed/31498881
http://dx.doi.org/10.1111/jgs.16149
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