Physiological resilience: mechanisms and consequences

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.