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Improving the resistance and resilience framework for aging and dementia studies

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dc.contributor.author Arenaza Urquijo, Eider M.
dc.contributor.author Vemuri, Prashanthi
dc.date.accessioned 2020-05-25T07:11:29Z
dc.date.available 2020-05-25T07:11:29Z
dc.date.issued 2020
dc.identifier.citation Arenaza-Urquijo EM, Vemuri P. Improving the resistance and resilience framework for aging and dementia studies. Alzheimers Res Ther. 2020 Apr 14; 12(1):41. DOI: 10.1186/s13195-020-00609-2
dc.identifier.issn 1758-9193
dc.identifier.uri http://hdl.handle.net/10230/44653
dc.description.abstract Background: The "resistance vs resilience" to Alzheimer's disease (AD) framework (coping vs avoiding) has gained interest in the field in the last year. In this viewpoint, our effort is (i) to provide clarity to the usage of the framework in the context of the ATN (amyloid/tau/neurodegeneration) system as well as in lifespan and cognitive aging studies and (ii) to discuss the challenges of matching these concepts to specific biological mechanisms. Main body: In the context of the ATN system, the main goal of the resistance vs resilience framework is to make a fundamental distinction between risk factors that may help halt the development of AD pathologies (AT) ("resistance") vs delay processes downstream to AT, i.e., neurodegeneration (N) and the clinical expression of the disease ("resilience"). The process of resilience in dementia and aging research should be envisioned as a process that is developed over the lifespan. Greater neurobiological capital to start with (initial brain reserve), maintaining brain structure and function (brain maintenance), or greater adaptability of cognitive strategies to perform a task (cognitive reserve) could all contribute to higher resilience to pathologies later in life. Simply put, resilience is not only a response to pathological processes (i.e. increased brain function to compensate for increasing AD pathology) but also reflects individual differences in brain structure and function that can be built over the lifespan (e.g., through education, lifetime cognitive, and physical activities). Further, the resistance vs resilience terminology can be extended to study other pathological processes such as cerebrovascular lesions, Lewy body disease, or TDP-43. However, some challenges do exist: (i) when studying multiple neuropathologies, the study design and framework will drive the usage of terminology; (ii) it is unavoidable that the measurements of resilience (brain structure and function) will reflect both the effect of pathologies and the impact of several risk and protective factors throughout the lifespan. Therefore, identifying resilience brain markers across lifespan, aging, and dementia studies, notably with longitudinal study designs, will be an important step towards understanding mechanisms of action. Conclusions: While the field advances towards consensus definitions of existing concepts, the resistance vs resilience terminology may provide clarity in the communication of results in aging and dementia studies as well as provide a framework for the development of both hypotheses and study designs.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher BioMed Central
dc.rights Copyright © The Author(s) 2020. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to th
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Improving the resistance and resilience framework for aging and dementia studies
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1186/s13195-020-00609-2
dc.subject.keyword Alzheimer’s disease
dc.subject.keyword Cognitive reserve
dc.subject.keyword Lifestyle
dc.subject.keyword Resilience
dc.subject.keyword Resistance
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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