Supporting resilience of older adults with cognitive decline requires a multi-level system approach

The concept of resilience, i.e., the capacity of a system to bounce back after a stressor, is gaining interest across many fields of science, policy and practice. To date, resilience research in people with cognitive decline has predominantly addressed the early stages of decline. We propose that: (1) resilience is a relevant concept in all stages of cognitive decline; and (2) a socioecological, multisystem perspective on resilience is required to advance understanding of, and care and support for people with cognitive decline and their support networks. We substantiate our position with literature and examples. Resilience helps to understand differences in response to risk factors of (further) cognitive decline and informs personalised prevention. In a curative context, interventions to strengthen resilience aim to boost recovery from cognitive decline. In care for people with dementia, resilience focused interventions can strengthen coping mechanisms to maintain functioning and wellbeing of the individual and their support network. A good example of improving resilience in the social and policy context is the introduction of age-friendly cities and dementia-friendly communities. Good care for people with cognitive decline requires a health and social care system that can adapt to changes in demand. Given the interdependency of resilience at micro-, meso- and macro-levels, an integrative socioecological perspective is required. Applying the concept of resilience in the field of cognitive decline opens new horizons for research to improve understanding, predicting, intervening on health and social care needs for the increasing population with cognitive decline.

Automated summary

The concept of resilience, which refers to the system's ability to bounce back after stress, is gaining interest across various fields. This paper argues that resilience is relevant throughout all stages of cognitive decline, and a socioecological, multisystem perspective is needed to understand and support individuals with cognitive decline. The paper provides evidence and examples to substantiate this argument. Resilience can help to understand responses to risk factors and inform personalized prevention, as well as interventions to strengthen recovery and coping mechanisms in care for people with cognitive decline. The application of resilience in this field opens new horizons for research and improving health and social care for the increasing population with cognitive decline.