Abstract：
OBJECTIVE: To investigate the determinants of resilience phenotype in aging, operationalized as the maintenance of cognitive, physical, and psychological health in very old individuals (80+), we investigated the structure and interrelated impact of the main resilience-enhancing factors, which are usually studied in separate research fields.
METHODS: Participants were older adults without dementia recruited for the fifth wave of the InveCe.Ab population-based cohort study (aged 83-87 years). Multidimensional evaluation comprised blood sampling, social and lifestyle survey, geriatric and neuropsychological assessment. We classified resilient individuals as displaying normal cognition, functional independence, and mental health. First, we performed exploratory factor analysis (EFA) to examine the underlying structure of the relevant cognitive, lifestyle, physical, and psychological resilience-enhancing factors. The factors obtained were included as predictors of the resilience phenotype in the logistic regression model, controlling for sociodemographic and cumulative exposure to physical and psychosocial stressors, including COVID-19 infection.
RESULTS: Among the 404 enrolled participants, 153 (38%) exhibited the resilience phenotype. EFA resulted in the identification of 6 factors (59% of variance): cognitive reserve, affective reserve, insecure attachment, current lifestyle, physical reserve, and avoidant attachment. Among these factors, cognitive reserve, affective reserve, and current lifestyle significantly and independently predicted resilience status, controlling for cumulative exposure to age-related stressors and COVID-19 infection.
CONCLUSIONS: Our findings showed that, even in very old age, both early and late life modifiable factors affect individuals\' ability to adapt to the aging process, thus confirming the importance of a life-course approach to improve health outcomes in the aged population.
METHODS: Participants were older adults without dementia recruited for the fifth wave of the InveCe.Ab population-based cohort study (aged 83-87 years). Multidimensional evaluation comprised blood sampling, social and lifestyle survey, geriatric and neuropsychological assessment. We classified resilient individuals as displaying normal cognition, functional independence, and mental health. First, we performed exploratory factor analysis (EFA) to examine the underlying structure of the relevant cognitive, lifestyle, physical, and psychological resilience-enhancing factors. The factors obtained were included as predictors of the resilience phenotype in the logistic regression model, controlling for sociodemographic and cumulative exposure to physical and psychosocial stressors, including COVID-19 infection.
RESULTS: Among the 404 enrolled participants, 153 (38%) exhibited the resilience phenotype. EFA resulted in the identification of 6 factors (59% of variance): cognitive reserve, affective reserve, insecure attachment, current lifestyle, physical reserve, and avoidant attachment. Among these factors, cognitive reserve, affective reserve, and current lifestyle significantly and independently predicted resilience status, controlling for cumulative exposure to age-related stressors and COVID-19 infection.
CONCLUSIONS: Our findings showed that, even in very old age, both early and late life modifiable factors affect individuals\' ability to adapt to the aging process, thus confirming the importance of a life-course approach to improve health outcomes in the aged population.
摘要：
目的：研究衰老中韧性表型的决定因素，作为认知的维持，物理，和心理健康在非常老的人（80+），我们调查了主要的韧性增强因素的结构和相互关联的影响，通常在不同的研究领域进行研究。
方法：参与者是未参加第五波InveCe的痴呆的老年人。基于Ab人群的队列研究（83-87岁）。多维评估包括血液采样，社会和生活方式调查，老年和神经心理学评估。我们将有弹性的个体归类为表现出正常的认知，功能独立，和心理健康。首先,我们进行了探索性因素分析(EFA)来检查相关认知的潜在结构，生活方式,物理，和心理韧性增强因素。将获得的因素作为弹性表型的预测因子纳入逻辑回归模型，控制社会人口统计学和累积暴露于身体和心理社会压力源，包括COVID-19感染。
结果：在404名注册参与者中，153（38％）表现出弹性表型。EFA导致6个因素的识别（差异的59%）：认知储备，情感储备，不安全的附件，当前的生活方式,实物储备,和回避的依恋。在这些因素中,认知储备,情感储备，和当前的生活方式显著和独立预测的弹性状态，控制与年龄相关的应激源和COVID-19感染的累积暴露。
结论：我们的研究结果表明，即使在很老的时候，早期和晚期可改变的因素都会影响个体适应衰老过程的能力，从而证实了在老年人口改善健康结果的生命历程方法的重要性.
方法：参与者是未参加第五波InveCe的痴呆的老年人。基于Ab人群的队列研究（83-87岁）。多维评估包括血液采样，社会和生活方式调查，老年和神经心理学评估。我们将有弹性的个体归类为表现出正常的认知，功能独立，和心理健康。首先,我们进行了探索性因素分析(EFA)来检查相关认知的潜在结构，生活方式,物理，和心理韧性增强因素。将获得的因素作为弹性表型的预测因子纳入逻辑回归模型，控制社会人口统计学和累积暴露于身体和心理社会压力源，包括COVID-19感染。
结果：在404名注册参与者中，153（38％）表现出弹性表型。EFA导致6个因素的识别（差异的59%）：认知储备，情感储备，不安全的附件，当前的生活方式,实物储备,和回避的依恋。在这些因素中,认知储备,情感储备，和当前的生活方式显著和独立预测的弹性状态，控制与年龄相关的应激源和COVID-19感染的累积暴露。
结论：我们的研究结果表明，即使在很老的时候，早期和晚期可改变的因素都会影响个体适应衰老过程的能力，从而证实了在老年人口改善健康结果的生命历程方法的重要性.
