Measuring Physical Resilience in Older Adults Cathleen ColnEmeric

Measuring Physical Resilience in Older Adults Cathleen Colón-Emeric, MD, MHS cathleen. colonemeric@duke. edu

Objectives Objective 1: Define physical resilience and describe its potential for improving healthspan in older adults. Objective 2: Describe 3 types of measurement approaches and give examples of how each can be used in geriatric research All Rights Reserved, Duke Medicine 2007

All Rights Reserved, Duke Medicine 2007

Working Definitions Resilience = an individual’s ability to withstand or recover from functional decline following acute or chronic health stressors Resiliencies = resilience within an organ system to a particular stressor Reserve = potential capacity of a cell, tissue, or organ system to function beyond its basal level in response to demands (stressors) All Rights Reserved, Duke Medicine 2007

Resilience All Rights Reserved, Duke Medicine 2007

Related concept of Frailty All Rights Reserved, Duke Medicine 2007

Geroscience – The Pillars of Aging From Kennedy et al. Cell 159; 2014 All Rights Reserved, Duke Medicine 2007

Working Conceptual Model Physical Resilience Stressor Outcomes All Rights Reserved, Duke Medicine 2007 Environment Social Psychology Reserve Pillars of Aging

Measuring Resilience Zimmerman S et al. Arch Phys Med Rehabil 2006; 87: 430 -6 All Rights Reserved, Duke Medicine 2007

Measuring Resilience Adapted from Kirkland JL et al. Resilience in Aging Mice: Proceedings of a workshop at the National Institutemon Aging, In Press (Kirkland, 2016) All Rights Reserved, Duke Medicine 2007

Measurement Challenges • Define resiliency phenotypes using functional trajectories – Individual patient level (Dr. Manning) – Population level using (Dr. Prvu-Bettger) • Validate cross-sectional measures that predict recovery – Clinical tests (Dr. Studenski) – Biomarkers (Dr. Belsky) All Rights Reserved, Duke Medicine 2007

Discussion and Questions All Rights Reserved, Duke Medicine 2007