Introduction

Resilience, the ability to respond to stressors by maintaining or rapidly returning to normal homeostasis, serves as a new paradigm to improve the care of older adults. However, resilience research in oncology is nascent. We aimed to describe the current research landscape on physical, cognitive, and psychosocial resilience in older cancer patients.

Materials and Methods

We searched PubMed/MEDLINE from inception to January 28, 2022 for records with the terms “resilient OR resilience OR resiliency.” We included studies that focused on persons over age 65 with cancer and assessed physical, cognitive, or psychological resilience. We excluded studies that did not report original data; did not have the full text available; assessed resilience on fewer than three time points; and published in non-English languages. Definitions and measures of resilience were extracted and categorized using qualitative analysis.

Results

Of 473 articles screened, we found 29 articles that met criteria for inclusion in our review. There was a high degree of heterogeneity in the definitions and measures of resilience. Resilience was defined as robustness/resistance to decline (n = 11), recovery from trauma/stressor (n = 7), and adaptive and proactive coping behaviors (n = 6). Ten papers did not define resilience. 21 studies utilized longitudinal analysis, five studies used randomized and nonrandomized control trials, and four studies assessed pre-post analysis. Stressors included cancer diagnosis (n = 18), chemotherapy (n = 3), radiation (n = 3), acute illness (n = 3), surgery (n = 2), and hematopoietic cell transplant (n = 1).

Discussion

Evidence for predictors and determinants of resilience in older adults with cancer is limited by the absence of standardized definitions and measurements. There is a fundamental need for a more precise definition, measures, and understanding of the physiologic mechanisms underlying the response to the physical, cognitive, and psychosocial stressors of cancer and its treatments.

中文翻译：

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老年癌症患者的复原力：范围界定文献综述

介绍

恢复力，即通过维持或迅速恢复正常体内平衡来应对压力源的能力，是改善老年人护理的新范例。然而，肿瘤学的弹性研究才刚刚起步。我们的目的是描述当前关于老年癌症患者的身体、认知和社会心理复原力的研究概况。

材料和方法

我们在 PubMed/MEDLINE 中搜索了从开始到 2022 年 1 月 28 日的记录，以查找包含术语“resilient OR resilience OR resiliency”的记录。我们纳入了针对 65 岁以上癌症患者的研究，并评估了他们的身体、认知或心理复原力。我们排除了没有报告原始数据的研究；没有可用的全文；在少于三个时间点评估弹性；并以非英语语言出版。使用定性分析提取和分类弹性的定义和措施。

结果

在筛选的 473 篇文章中，我们发现 29 篇文章符合纳入我们审查的标准。韧性的定义和衡量标准存在高度异质性。弹性被定义为稳健性/抵抗衰退（n  = 11），从创伤/压力源中恢复（n  = 7），以及适应性和主动应对行为（n  = 6）。十篇论文没有定义弹性。21 项研究使用纵向分析，五项研究使用随机和非随机对照试验，四项研究评估前后分析。压力源包括癌症诊断 ( n  = 18)、化疗 ( n  = 3)、放疗 (n = 3)、急性疾病 (n = 3)、手术 ( n = 2), 和造血细胞移植 (n = 1)。

讨论

由于缺乏标准化的定义和测量，有关老年人癌症恢复力的预测因素和决定因素的证据有限。对癌症及其治疗的身体、认知和社会心理应激反应背后的生理机制有更精确的定义、测量和理解的基本需求。