Psychobiological factors of resilience and depression in late life.

In contrast to traditional perspectives of resilience as a stable, trait-like characteristic, resilience is now recognized as a multidimentional, dynamic capacity influenced by life-long interactions between internal and environmental resources. We review psychosocial and neurobiological factors associated with resilience to late-life depression (LLD). Recent research has identified both psychosocial characteristics associated with elevated LLD risk (e.g., insecure attachment, neuroticism) and psychosocial processes that may be useful intervention targets (e.g., self-efficacy, sense of purpose, coping behaviors, social support). Psychobiological factors include a variety of endocrine, genetic, inflammatory, metabolic, neural, and cardiovascular processes that bidirectionally interact to affect risk for LLD onset and course of illness. Several resilience-enhancing intervention modalities show promise for the prevention and treatment of LLD, including cognitive/psychological or mind-body (positive psychology; psychotherapy; heart rate variability biofeedback; meditation), movement-based (aerobic exercise; yoga; tai chi), and biological approaches (pharmacotherapy, electroconvulsive therapy). Additional research is needed to further elucidate psychosocial and biological factors that affect risk and course of LLD. In addition, research to identify psychobiological factors predicting differential treatment response to various interventions will be essential to the development of more individualized and effective approaches to the prevention and treatment of LLD

Quality of life: Conceptual challenges in exploring the role of ICT in active ageing

The chapter aims to examine the definitional challenges associated with the term quality of life, measurement challenges, the challenges associated with enhancing quality of life, and the role of information and communication technologies (ICT) in quality of life in old age, and finally comments on the challenges of a modern information society for older people. The term quality of life started as a social scientific index of the relative well-being of whole populations, i.e. the state of states. Nowadays quality of life is more likely to be viewed as an individualized aspect of the modern psyche. This shift in conceptualization is problematic in that, if quality of life is individualized, it cannot be meaningful to assess it in the same way for everyone. Nevertheless, over the years a vast range of methods of measuring quality of life has emerged, leading to several measurement challenges. Wealth, health and social relations have all been found to be prime determinants of subjective quality of life; for ICT to enhance quality of life for older people they need to mediate the relationships between these three important factors and quality of life. To date there is relatively little evidence that ICT has improved the quality of life of older people. Suggestions are made as to why ICT is unlikely to influence life quality for older citizens. The chapter is drawn to a close by asking if quality of life is a meaningless term and if the future is bleak for old people in a modern information society. The answer to both questions is no

Sleep and inflammation in resilient aging.

Sleep quality is important to health, and increasingly viewed as critical in promoting successful, resilient aging. In this review, the interplay between sleep and mental and physical health is considered with a focus on the role of inflammation as a biological pathway that translates the effects of sleep on risk of depression, pain and chronic disease risk in aging. Given that sleep regulates inflammatory biologic mechanisms with effects on mental and physical health outcomes, the potential of interventions that target sleep to reduce inflammation and promote health in aging is also discussed

Gait and cognition: mapping the global and discrete relationships in ageing and neurodegenerative disease

Recent research highlights the association of gait and cognition in older adults but a stronger understanding is needed to discern coincident pathophysiology, patterns of change, examine underlying mechanisms and aid diagnosis. This structured review mapped associations and predictors of gait and cognition in older adults with and without cognitive impairment, and Parkinson's disease. Fifty papers out of an initial yield of 22,128 were reviewed and a model of gait guided analysis and interpretation. Associations were dominated by the pace domain of gait; the most frequently studied domain. In older adults pace was identified as a predictor for cognitive decline. Where comprehensive measurement of gait was conducted, more specific pathological patterns of association were evident highlighting the importance of this approach. This review confirmed a robust association between gait and cognition and argues for a selective, comprehensive measurement approach. Results suggest gait may be a surrogate marker of cognitive impairment and cognitive decline. Understanding the specific nature of this relationship is essential for refinement of diagnostics and development of novel therapies

Determinants of frailty development and progression using a multidimensional frailty index: Evidence from the English Longitudinal Study of Ageing

This work was supported by grant number 689592 "my-AHA" from the Horizon 2020 research funding framework of the European Commission (https://ec.europa.eu/programmes/horizon2020/en).Open Access articl