Physiological resilience: mechanisms and consequences

韧性，即从挑战中恢复过来的能力，随着年龄的增长而变得越来越差。例如，老年人从跌倒、感染或手术中完全恢复到患病前状态的可能性较小。对日常生活挑战的反应也是如此；例如，老年人在站立时失去了防止血压下降的能力，他们的血压随后需要比年轻人更长的时间才能恢复正常。同样，老年人进餐后的循环葡萄糖(一种简单的糖)水平比年轻人需要更长的时间才能恢复正常。我们认为，弹性丧失是不良结局的早期标志，特别是进行性功能丧失、疾病风险增加、虚弱和死亡。我们将测量在临床中对可控应激源的反应(例如，站起来、体力活动、思考)。这将使我们能够确定一个人是否表现出早期迹象，表明他们未来将面临更大的疾病和残疾风险。潜在地，我们可以使用韧性测量来识别高危人群，并可能找到新的方法进行干预，以提高他们的韧性，这将导致更好的结果。

Resilience, the ability to ‘bounce back’ from a challenge, gets worse with age. For example, older people are less likely to make a full recovery to their pre-illness state from a fall, infection or surgery. This is also true for the response to daily life challenges; for example, older people lose the ability to prevent the fall in blood pressure on standing, and their blood pressure subsequently takes longer to return to normal, than younger people. Similarly, levels of circulating glucose (a simple sugar) in response to a meal takes longer to return to normal in older than younger people. We suggest that loss of resilience is an early marker of poor outcomes, specifically progressive loss of function, increased risk of disease, frailty and death. We will measure responses to controlled stressors in the clinic (e.g. standing up, physical activity, thinking). This will allow us to determine if a person shows early signs that they will be at more risk of disease and disability in the future. Potentially, we could use measures of resilience to identify people at high risk and may find new ways to intervene to improve their resilience which would lead to better outcomes.