title: Physical Resilience in Older Adults: Systematic Review and Development of an Emerging Construct.
abstract: BACKGROUND
  Resilience has been described in the psychosocial literature as the capacity to maintain or regain well-being during or after adversity. Physical resilience is a newer concept that is highly relevant to successful aging. Our objective was to characterize the emerging construct of resilience as it pertains to physical health in older adults, and to identify gaps and opportunities to advance research in this area.
  
  
  METHODS
  We conducted a systematic review to identify English language papers published through January 2015 that apply the term "resilience" in relation to physical health in older adults. We applied a modified framework analysis to characterize themes in implicit or explicit definitions of physical resilience.
  
  
  RESULTS
  Of 1,078 abstracts identified, 49 articles met criteria for inclusion. Sixteen were letters or concept papers, and only one was an intervention study. Definitions of physical resilience spanned cellular to whole-person levels, incorporated many outcome measures, and represented three conceptual themes: resilience as a trait, trajectory, or characteristic/capacity.
  
  
  CONCLUSIONS
  Current biomedical literature lacks consensus on how to define and measure physical resilience. We propose a working definition of physical resilience at the whole person level: a characteristic which determines one's ability to resist or recover from functional decline following health stressor(s). We present a conceptual framework that encompasses the related construct of physiologic reserve. We discuss gaps and opportunities in measurement, interactions across contributors to physical resilience, and points of intervention.
authors.affiliation: Duke University Center for the Study of Aging, Durham, North Carolina. Department of Medicine, Duke University, Durham, North Carolina. Durham VA Geriatrics Research, Education, and Clinical Center (GRECC), North Carolina. Department of Ophthalmology, Duke University, Durham, North Carolina. heather.whitson@duke.edu.
authors.forename: Heather E
authors.initials: HE
authors.lastname: Whitson
authors.affiliation: Duke University Center for the Study of Aging, Durham, North Carolina. Durham VA Health Services Research and Development, North Carolina.
authors.forename: Wei
authors.initials: W
authors.lastname: Duan-Porter
authors.affiliation: Duke University Center for the Study of Aging, Durham, North Carolina. Department of Medicine, Duke University, Durham, North Carolina. Durham VA Geriatrics Research, Education, and Clinical Center (GRECC), North Carolina.
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Schmader
authors.affiliation: Duke University Center for the Study of Aging, Durham, North Carolina. Department of Medicine, Duke University, Durham, North Carolina. Durham VA Geriatrics Research, Education, and Clinical Center (GRECC), North Carolina.
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Morey
authors.affiliation: Duke University Center for the Study of Aging, Durham, North Carolina. Department of Medicine, Duke University, Durham, North Carolina. Durham VA Geriatrics Research, Education, and Clinical Center (GRECC), North Carolina.
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Cohen
authors.affiliation: Duke University Center for the Study of Aging, Durham, North Carolina. Department of Medicine, Duke University, Durham, North Carolina. Durham VA Geriatrics Research, Education, and Clinical Center (GRECC), North Carolina.
authors.forename: Cathleen S
authors.initials: CS
authors.lastname: Colón-Emeric
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology* / Q000523:psychology*; D006801:Humans; D010809:Physical Fitness / Q000502:physiology* / Q000523:psychology*; D055500:Resilience, Psychological
keywords: Disablement process; Frailty; Physical function; Physiology; Successful aging