Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Record number 553960
Title Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older Adults
Author(s) Gijzel, Sanne M.W.; Whitson, Heather E.; Leemput, Ingrid A. van de; Scheffer, Marten; Asselt, Dieneke van; Rector, Jerrald L.; Olde Rikkert, Marcel G.M.; Melis, René J.F.
Source Journal of the American Geriatrics Society (2019). - ISSN 0002-8614
DOI https://doi.org/10.1111/jgs.16149
Department(s) Aquatic Ecology and Water Quality Management
WIMEK
Publication type Refereed Article in a scientific journal
Publication year 2019
Keyword(s) adaptive capacity - complex dynamical system - personalized medicine - resistance - time series analysis
Abstract

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.

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