MEASURING PHYSICAL RESILIENCE IN OLDER ADULTS: TRAJECTORY, PHENOTYPE, AND AGE DISCREPANCY APPROACHES

Abstract As the global population ages, identifying ways to optimize recovery following acute and chronic stressors will be important to public health. Understanding “physical resilience”, a characteristic at the whole person level which determines an individual’s ability to resist functional decline or recover physical health following a stressor, is therefore of intense interest. Physical resilience is thought to be constrained in part by underlying physiologic reserve across organ systems, and further influenced by factors such as genetics, the environment, and psychosocial factors including psychological resilience. Measuring physical resilience is a critical but challenging first step in identifying potential pathways for intervention. This symposium will discuss three potential approaches to measuring physical resilience in older adults, with examples from ongoing research by an interprofessional group of investigators. First, we describe the use of functional trajectories to measure physical resilience, both at an individual patient level using perioperative activity monitors, and at a population level using administrative data. Second, we describe attempts to define a resilient phenotype with in-home video telehealth gait and balance assessment and using dual task stress testing. Finally, we describe an age discrepancy approach to measuring physical resilience by quantifying the difference between observed and predicted levels of readily available biomarkers based on chronological age. Once validated as predictors of functional outcomes following stressors in diverse populations, these measurements can be used in studies aimed at improving physical resilience and active life expectancy in older adults regardless of the underlying stressor.

Duke Scholars

Author Cathleen Sellner Colon-Emeric Medicine, Geriatrics and Palliative Care