Supporting Resilience of Older Adults with Cognitive Decline Requires a Multi-Level System Approach

Abstract

The concept of resilience, i.e., the capacity of a system to bounce back after a stressor, is gaining interest across many fields of science, policy and practice. To date, resilience research in people with cognitive decline has predominantly addressed the early stages of decline. We propose that: (1) resilience is a relevant concept in all stages of cognitive decline; and (2) a socioecological, multisystem perspective on resilience is required to advance understanding of, and care and support for people with cognitive decline and their support networks. We substantiate our position with literature and examples. Resilience helps to understand differences in response to risk factors of (further) cognitive decline and informs personalised prevention. In a curative context, interventions to strengthen resilience aim to boost recovery from cognitive decline. In care for people with dementia, resilience focused interventions can strengthen coping mechanisms to maintain functioning and wellbeing of the individual and their support network. A good example of improving resilience in the social and policy context is the introduction of age-friendly cities and dementia-friendly communities. Good care for people with cognitive decline requires a health and social care system that can adapt to changes in demand. Given the interdependency of resilience at micro-, meso- and macro-levels, an integrative socioecological perspective is required. Applying the concept of resilience in the field of cognitive decline opens new horizons for research to improve understanding, predicting, intervening on health and social care needs for the increasing population with cognitive decline.

A palliative care goals model for people with dementia and their family: Consensus achieved in an international Delphi study

“…Further research may consider how the model may support resilience of the wider networks in the environment around the person with dementia. 66 Understanding diversity in meaning of life prolongation as a care goal is important for the use both of this model and the white paper model that also included it. The usefulness of life prolongation as a goal of care should also be understood from the perspective of persons with dementia and their family to best serve their interests.…”

Elucidating Multimodal Imaging Patterns in Accelerated Brain Aging: Heterogeneity through a Discriminant Analysis Approach Using the UK Biobank Dataset

“…Traditional brain-aging research has categorized brain aging into distinct categories: resilient brain aging (RBA) [10][11][12], normal brain aging, and accelerated brain aging (ABA), occasionally referred to as advanced brain aging [13,14]. Such studies have revealed that RBA is associated with a greater resistance to the risk of neurodegenerative diseases like Alzheimer's disease (AD).…”

Understanding the Temporal Dynamics of Accelerated Brain Aging and Resilient Brain Aging: Insights from Discriminative Event-Based Analysis of UK Biobank Data

“…In the realm of neuroscientific research, brain aging in cognitively normal individuals has been meticulously classified to include resilient brain aging (RBA) [5][6][7], normal brain aging, and accelerated brain aging (ABA) [5,8,9], sometimes colloquially termed advanced brain aging. RBA is a concept that describes the ability of certain individuals to maintain neural integrity relatively well as they age.…”