老年慢性病患者身体复原力的研究进展
Research Progress on Physical Resilience in Elderly Patients with Chronic Disease
DOI: 10.12677/ns.2026.154133, PDF,   
作者: 樊荣荣*, 刘学欣, 张佳佳, 王 灿, 陈 雪, 李乐莹:湖北医药学院护理学院,湖北 十堰;李 玲#:湖北医药学院附属国药东风总医院,湖北 十堰
关键词: 老年人慢性病身体复原力综述The Elderly Chronic Disease Physical Resilience Review
摘要: 在人口老龄化与慢性病共病日益加剧的背景下,老年患者的身体复原力已成为实现健康老龄化的关键。本文通过系统梳理国内外文献,回顾了身体复原力的概念模型、主要测量工具(包括量表法、表型法和轨迹法)及其在老年慢病人群中的应用现状,并从社会人口学、健康、心理、社会支持和生活方式等多维度归纳其影响因素。结果表明,国内身体复原力研究尚处于初步探索阶段,未来需加强纵向研究,整合多模态数据构建综合评估体系,并发展基于循证的个性化干预策略,以有效提升我国老年慢病患者的健康功能与生活质量。
Abstract: Against the backdrop of population aging and the rising burden of chronic multimorbidity, physical resilience has emerged as a cornerstone of healthy aging. This article systematically reviews domestic and international literature to summarize conceptual models of physical resilience, principal measurement approaches (scale-based, phenotype-based, and trajectory-based), and their current application among older adults with chronic diseases. We also synthesize determinants across sociodemographic, health-related, psychological, social-support, and lifestyle dimensions. Findings indicate that research on physical resilience in China is still in its infancy. Future work should prioritize longitudinal designs, integrate multimodal data to build a comprehensive assessment system, and develop evidence-based, personalized interventions to improve health functioning and quality of life for older Chinese adults living with chronic conditions.
文章引用:樊荣荣, 刘学欣, 张佳佳, 王灿, 陈雪, 李乐莹, 李玲. 老年慢性病患者身体复原力的研究进展[J]. 护理学, 2026, 15(4): 297-306. https://doi.org/10.12677/ns.2026.154133

参考文献

[1] 杜鹏. 中国人口老龄化现状与社会保障体系发展[J]. 社会保障评论, 2023, 7(2): 31-47.
[2] 王丽敏, 陈志华, 张梅, 等. 中国老年人群慢性病患病状况和疾病负担研究[J]. 中华流行病学杂志, 2019, 40(3): 277-283.
[3] 李若雨, 刘鑫, 林萍, 等. 三级联动延续护理模式在慢性非传染性疾病患者管理中的应用进展[J]. 广西医学, 2025, 47(9): 1251-1256.
[4] 赵玉玲, 顾政平, 张雪莹. 慢性非传染性疾病医防融合研究进展与挑战[J]. 中国全科医学, 2024, 27(31): 3953-3957.
[5] Rudnicka, E., Napierała, P., Podfigurna, A., Męczekalski, B., Smolarczyk, R. and Grymowicz, M. (2020) The World Health Organization (WHO) Approach to Healthy Ageing. Maturitas, 139, 6-11. [Google Scholar] [CrossRef] [PubMed]
[6] Wu, C., Li, Y., Marron, M.M., Odden, M.C., Newman, A.B. and Sanders, J.L. (2019) Quantifying and Classifying Physical Resilience among Older Adults: The Health, Aging, and Body Composition Study. The Journals of Gerontology: Series A, 75, 1960-1966. [Google Scholar] [CrossRef] [PubMed]
[7] Chhetri, J.K., Ma, L. and Chan, P. (2022) Physical Resilience: A Novel Approach for Healthy Aging. Journal of Frailty, Sarcopenia and Falls, 7, 29-31. [Google Scholar] [CrossRef] [PubMed]
[8] Angevaare, M.J., Roberts, J., van Hout, H.P.J., Joling, K.J., Smalbrugge, M., Schoonmade, L.J., et al. (2020) Resilience in Older Persons: A Systematic Review of the Conceptual Literature. Ageing Research Reviews, 63, Article 101144. [Google Scholar] [CrossRef] [PubMed]
[9] Southwick, S.M., Bonanno, G.A., Masten, A.S., Panter-Brick, C. and Yehuda, R. (2014) Resilience Definitions, Theory, and Challenges: Interdisciplinary Perspectives. European Journal of Psychotraumatology, 5, Article 25338.
[10] Resnick, B., Galik, E., Dorsey, S., Scheve, A. and Gutkin, S. (2011) Reliability and Validity Testing of the Physical Resilience Measure. The Gerontologist, 51, 643-652. [Google Scholar] [CrossRef] [PubMed]
[11] Whitson, H.E., Duan-Porter, W., Schmader, K.E., Morey, M.C., Cohen, H.J. and Colón-Emeric, C.S. (2016) Physical Resilience in Older Adults: Systematic Review and Development of an Emerging Construct. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 71, 489-495. [Google Scholar] [CrossRef] [PubMed]
[12] Chhetri, J.K., Xue, Q.L., Ma, L., Chan, P. and Varadhan, R. (2021) Intrinsic Capacity as a Determinant of Physical Resilience in Older Adults. The Journal of Nutrition, Health and Aging, 25, 1006-1011. [Google Scholar] [CrossRef] [PubMed]
[13] 马一帆, 孙文霞, 郭林夕, 等. 老年人躯体复原力的概念分析[J]. 中华护理教育, 2025, 22(5): 611-616.
[14] 芮冬, 赵力博, 刘霖. 老年人身体弹性研究现况[J]. 中华老年多器官疾病杂志, 2024, 23(9): 713-716.
[15] 裴丽, 李伟, 张馨予, 等. 老年人机体复原力量表的信效度检验[J]. 护理研究, 2025, 39(5): 799-802.
[16] Hu, F.W., Lin, C.H., Yueh, F.R., et al. (2022) Development and Psychometric Evaluation of the Physical Resilience Instrument for Older Adults (PRIFOR). BMC Geriatrics, 22, Article No. 229. [Google Scholar] [CrossRef] [PubMed]
[17] 李佳欣. 老年人身体复原力量表的修订及在膝骨关节炎患者中的应用[D]: [硕士学位论文]. 开封: 河南大学, 2024.
[18] Hadley, E.C., Kuchel, G.A., Newman, A.B., Allore, H.G., Bartley, J.M., Bergeman, C.S., et al. (2017) Report: NIA Workshop on Measures of Physiologic Resiliencies in Human Aging. The Journals of Gerontology: Series A, 72, 980-990. [Google Scholar] [CrossRef] [PubMed]
[19] Bowling, C.B., Berkowitz, T.S.Z., Burrows, B.T., Ma, J.E., Whitson, H.E., Smith, B., et al. (2024) Trajectories of Physical Resilience among Older Veterans with Stage 4 CKD. American Journal of Kidney Diseases, 84, 154-163. [Google Scholar] [CrossRef] [PubMed]
[20] Sheshadri, A. and Elia, J.R. (2022) Physical Resilience in Older Patients Incident to Hemodialysis: Can Following Trajectories Improve Our Ability to Intervene on Functional Decline? Kidney International Reports, 7, 1927-1929. [Google Scholar] [CrossRef] [PubMed]
[21] 高秦妮, 郭慧鑫, 吴倩莲, 等. 老年压力性损伤患者躯体复原力现状与发展轨迹的差异性研究[J]. 军事护理, 2025, 42(6): 56-60.
[22] 赵琪, 高俊平, 高凯霞, 等. 老年膀胱癌尿路造口患者躯体复原力现状及其影响因素分析[J]. 军事护理, 2024, 41(9): 21-24.
[23] 祁琳, 来纯云, 赵雪桐, 等. 机体复原力复合指标对高龄社区获得性肺炎患者预后的预测效果[J]. 国际老年医学杂志, 2024, 45(5): 534-540.
[24] 董澳华, 张会君, 孔令慧. 老年人身体复原力量表在社区老年人中的心理测量学评价[J]. 护理研究, 2025, 39(1): 79-85.
[25] 徐婷婷, 申雪花, 柳秋实, 等. 社区老年人身体复原力现状及影响因素分析[J]. 中国医药导报, 2025, 22(14): 30-34.
[26] Hu, F.W., Li, Y.P., Chang, C.M., et al. (2024) Development and Testing of a Four-Item Version of the Physical Resilience Instrument for Older Adults (PRIFOR-4). The Journal of Nutrition, Health and Aging, 28, Article 100250. [Google Scholar] [CrossRef] [PubMed]
[27] Li, J., Liu, P., Zhang, Y., Wang, G., Zhou, Y., Xing, Y., et al. (2024) Development of the Clinical Physical Resilience Assessment Scale (CHEES) in Chinese Older Adults. The Journal of Frailty & Aging, 13, 125-130. [Google Scholar] [CrossRef] [PubMed]
[28] Xing, Y., Liu, P., Yu, W., Zhao, Y., Wang, Z., Wu, Y., et al. (2025) Reliability and Validity of the Clinical Physical Resilience Assessment Scale (CHEES) in Community-Dwelling Older Adults. Experimental Gerontology, 208, Article 112818. [Google Scholar] [CrossRef] [PubMed]
[29] Colón-Emeric, C., Pieper, C.F., Schmader, K.E., Sloane, R., Bloom, A., McClain, M., et al. (2020) Two Approaches to Classifying and Quantifying Physical Resilience in Longitudinal Data. The Journals of Gerontology: Series A, 75, 731-738. [Google Scholar] [CrossRef] [PubMed]
[30] Kolk, D., Melis, R.J.F., MacNeil-Vroomen, J.L., Buurman, B.M., Reichardt, L.A., Aarden, J., et al. (2022) Physical Resilience in Daily Functioning among Acutely Ill Hospitalized Older Adults: The Hospital-ADL Study. Journal of the American Medical Directors Association, 23, 903.e1-903.e12. [Google Scholar] [CrossRef] [PubMed]
[31] Cosco, T.D., Kaushal, A., Hardy, R., Richards, M., Kuh, D. and Stafford, M. (2017) Operationalising Resilience in Longitudinal Studies: A Systematic Review of Methodological Approaches. Journal of Epidemiology and Community Health, 71, 98-104. [Google Scholar] [CrossRef] [PubMed]
[32] Colón-Emeric, C., Whitson, H.E., Pieper, C.F., Sloane, R., Orwig, D., Huffman, K.M., et al. (2019) Resiliency Groups Following Hip Fracture in Older Adults. Journal of the American Geriatrics Society, 67, 2519-2527. [Google Scholar] [CrossRef] [PubMed]
[33] Zhang, Z., Wang, J., Ma, B., Wang, J., Jia, Y. and Chen, O. (2023) Positive Self-Perceptions of Aging Increase Physical Resilience to Facilitate Social Re-Engagement of Older Adults Who Fall: Analysis Based on Health and Retirement Study Data. Archives of Physical Medicine and Rehabilitation, 104, 1253-1259. [Google Scholar] [CrossRef] [PubMed]
[34] Wang, X. and Luan, W. (2022) Research Progress on Digital Health Literacy of Older Adults: A Scoping Review. Frontiers in Public Health, 10, Article 906089. [Google Scholar] [CrossRef] [PubMed]
[35] Höltge, J., Samper-Ternent, R., García-Peña, C. and Gutiérrez-Robledo, L.M. (2020) A Longitudinal Study on Multidimensional Resilience to Physical and Psychosocial Stress in Elderly Mexicans. Journal of Aging and Health, 32, 1450-1463. [Google Scholar] [CrossRef] [PubMed]
[36] Colón-Emeric, C.S., Huang, J., Pieper, C.F., Bettger, J.P., Roth, D.L. and Sheehan, O.C. (2020) Cost Trajectories as a Measure of Functional Resilience after Hospitalization in Older Adults. Aging Clinical and Experimental Research, 32, 2595-2601. [Google Scholar] [CrossRef] [PubMed]
[37] Latham-Mintus, K. (2019) Exploring Racial and Ethnic Differences in Recovery Maintenance from Mobility Limitation. Journal of Aging and Health, 32, 384-393. [Google Scholar] [CrossRef] [PubMed]
[38] Rengifo, R.C., Bermejo-Pareja, F., López-Arrieta, J., et al. (2025) Development and Preliminary Validation of a Cognitive-Physical Frailty Index in an Older Adult Cohort: The NEDICES Study. The Journal of the Royal College of Physicians of Edinburgh, 2025, Article 459253377.
[39] Xue, Q.L., Laskow, T., Alzahrani, M.K., et al. (2025) Multivariate Profiling of Physical Resilience in Older Adults after Total Knee Replacement Surgery: Results from a Prospective Observational Study. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 80, glaf032. [Google Scholar] [CrossRef] [PubMed]
[40] Li, X. and Ma, L. (2024) From Biological Aging to Functional Decline: Insights into Chronic Inflammation and Intrinsic Capacity. Ageing Research Reviews, 93, Article 102175. [Google Scholar] [CrossRef] [PubMed]
[41] Cesari, M., Araujo de Carvalho, I., Amuthavalli Thiyagarajan, J., Cooper, C., Martin, F.C., Reginster, J., et al. (2018) Evidence for the Domains Supporting the Construct of Intrinsic Capacity. The Journals of Gerontology: Series A, 73, 1653-1660. [Google Scholar] [CrossRef] [PubMed]
[42] Hu, F.W., Yueh, F.R., Fang, T.J., et al. (2024) Testing a Conceptual Model of Physiologic Reserve, Intrinsic Capacity, and Physical Resilience in Hospitalized Older Patients: A Structural Equation Modelling. Gerontology, 70, 165-172. [Google Scholar] [CrossRef] [PubMed]
[43] Laskow, T., Zhu, J., Buta, B., Oni, J., Sieber, F., Bandeen-Roche, K., et al. (2022) Risk Factors for Non-Resilient Outcomes in Older Adults after Total Knee Replacement. The Journals of Gerontology: Series A, 77, 1915-1922. [Google Scholar] [CrossRef] [PubMed]
[44] Peeters, G., de Munck, I., Tooth, L. and Melis, R. (2024) Quantifying Physical Resilience after Knee or Hip Surgery in Older Australian Women Based on Long-Term Physical Functioning Trajectories. Gerontology, 70, 950-961. [Google Scholar] [CrossRef] [PubMed]
[45] Resnick, B., Klinedinst, N.J., Yerges-Armstrong, L., Choi, E.Y. and Dorsey, S.G. (2015) The Impact of Genetics on Physical Resilience and Successful Aging. Journal of Aging and Health, 27, 1084-1104. [Google Scholar] [CrossRef] [PubMed]
[46] Blume, J., Douglas, S.D. and Evans, D.L. (2011) Immune Suppression and Immune Activation in Depression. Brain, Behavior, and Immunity, 25, 221-229. [Google Scholar] [CrossRef] [PubMed]
[47] Lee, S. (2023) Exploring the Role of Resilience and Optimism during the COVID-19 Pandemic in Older European Adults. Research on Aging, 45, 643-653. [Google Scholar] [CrossRef] [PubMed]
[48] Gijzel, S.M.W., Rector, J., van Meulen, F.B., van der Loeff, R.S., van de Leemput, I.A., Scheffer, M., et al. (2020) Measurement of Dynamical Resilience Indicators Improves the Prediction of Recovery Following Hospitalization in Older Adults. Journal of the American Medical Directors Association, 21, 525-530. [Google Scholar] [CrossRef] [PubMed]
[49] Li, J., Chhetri, J.K. and Ma, L. (2022) Physical Resilience in Older Adults: Potential Use in Promoting Healthy Aging. Ageing Research Reviews, 81, Article 101701. [Google Scholar] [CrossRef] [PubMed]
[50] 谢君, 陈英, 黄背英, 等. 老年人健康状况及社会支持影响研究——基于2018年CLHLS数据[J]. 卫生经济研究, 2022, 39(7): 74-78.
[51] 胡斌, 钱香玲, 王琦, 等. 家庭支持对城市老年人健康自评的影响[J]. 中国老年学杂志, 2022, 42(6): 1487-1490.
[52] Kukihara, H., Yamawaki, N., Ando, M., Nishio, M., Kimura, H. and Tamura, Y. (2020) The Mediating Effect of Resilience between Family Functioning and Mental Well-Being in Hemodialysis Patients in Japan: A Cross-Sectional Design. Health and Quality of Life Outcomes, 18, Article No. 233. [Google Scholar] [CrossRef] [PubMed]
[53] Yeh, S.J. and Liu, Y. (2003) Influence of Social Support on Cognitive Function in the Elderly. BMC Health Services Research, 3, Article No. 9. [Google Scholar] [CrossRef] [PubMed]
[54] Duan-Porter, W., Cohen, H.J., Demark-Wahnefried, W., Sloane, R., Pendergast, J.F., Snyder, D.C., et al. (2016) Physical Resilience of Older Cancer Survivors: An Emerging Concept. Journal of Geriatric Oncology, 7, 471-478. [Google Scholar] [CrossRef] [PubMed]
[55] Hutchinson, A.N., Bergh, C., Kruger, K., Sűsserová, M., Allen, J., Améen, S., et al. (2021) The Effect of Probiotics on Health Outcomes in the Elderly: A Systematic Review of Randomized, Placebo-Controlled Studies. Microorganisms, 9, Article 1344. [Google Scholar] [CrossRef] [PubMed]
[56] Sotos-Prieto, M., Ortolá, R., López-García, E., Rodríguez-Artalejo, F. and García-Esquinas, E. (2020) Adherence to the Mediterranean Diet and Physical Resilience in Older Adults: The Seniors-ENRICA Cohort. The Journals of Gerontology: Series A, 76, 505-512. [Google Scholar] [CrossRef] [PubMed]
[57] Guida, J.L., Alfini, A., Lee, K.C., Miller, C., Riscuta, G., Rusch, H.L., et al. (2023) Integrating Sleep Health into Resilience Research. Stress and Health, 39, 22-27. [Google Scholar] [CrossRef] [PubMed]