This is a timely book, given the increasing concern about the ability of contemporary societies to provide adequate health care and welfare support to the rapidly growing numbers of older people throughout the world. The main message of the book is that the vast majority of older people have reserve capacities in all domains which enable them to not only cope with the inevitable challenges of older life but to thrive in the face of adversity and to experience ongoing developmental growth. The authors, leading figures in gerontological research over many years, have produced an accessible ‘state of the art’ review of the latest scientific research into what is possible for older adults to achieve and experience, with contributions from world experts in the many factors that contribute to resilience.
In the introduction, the editors maintain that there is a ‘paradigm shift’ occurring, from conceptualising resilience as recovery to pre-existing homeostasis towards ‘enhancing … overall health and functioning' – resilience results in personal growth. This is consistent with theories of resilience in children and adolescents, where most of the focus in resilience research has been up to now. The book represents a welcome extension of research into the early years into older age and in that respect takes a truly lifespan developmental approach. The book itself contributes to this paradigm shift, since it invites the reader to imagine what is possible during the later decades of life. It comprises a solid foundation upon which to build an exciting body of research, taking up many of the threads mentioned by the authors in the conclusions to their chapters.
The first chapter, by Fry and Debats, comprehensively reviews the growing literature on life strengths in relation to resilience and health. They emphasise that resilience development is a dynamic process, and importantly that everybody has the potential to become resilient. They make important points about the relative neglect of issues known to be important to older people, such as their existential and humanistic concerns and spirituality, areas likely to be of increasing interest to gerontologists over the next few years. Bauer and Park then emphasise that ‘growth is not just for the young’ and that the narrative in older age can be one of growth, not just decline.
The next chapter, by de Grey, is an entertaining and passionate argument for the use of gene therapy and other medical technology to prolong life indefinitely. While many would not agree that ageing is a disease, his argument is sure to stimulate discussion about the extent to which ageing consists of bodily decline. Uswatte and Taub then provide a clear and readable summary of current research into neuroplasticity, which turns on its head a common misconception that brain regeneration is not possible in old age. They discuss the effectiveness of Constraint-Induced Movement Therapy, a simple evidence-based procedure for recovery of nerve function after stroke or other trauma, demonstrating that non-use of the impaired body part is a learned response which can be overcome with training.
Hertzog and Jopp's chapter is a very good scholarly yet easy-to-read review of the vast research on cognitive ageing. They emphasise how metacognitive self-regulation (monitoring one's cognitive function and taking steps to remediate incipient problems) can be enhanced with training, even in people with dementia. Kern and Friedman then discuss the role of personality in resilience, regarding resilience as an ‘emerging attribute … that appears as a result of the appropriate combination of predisposition, behaviours and environmental circumstances’ (p. 177). This reinforces one of the optimistic themes of the book: resilience is not confined to people who are lucky enough to have a resilient personality, but can be developed by anyone.
In the next chapter, Fry and Debats describe an interesting study that shows how older widows are able to make use of their psycho-social resources, including spiritual resources, to bounce back after spousal bereavement. Martin et al. follow this up with their review of research into centenarians, reinforcing the interplay of personal, cognitive, social and economic resources. They make the important point that studying centenarians is not just of academic interest – we can all learn from centenarians about how to utilise our strengths and resources in order to have more enjoyable and healthier lives, regardless of how long we live. Ong and Bergeman focus on socio-emotional resilience, reinforcing the importance of social connection. They make the strong point that ‘resilience is not about trees. It's about forests’ (p. 252) – no one can become resilient on their own: resilience develops in an ecological context. Kessler and Staudinger then cite evidence to show that older people can draw upon their emotional reserve capacities to develop emotional resilience.
Moen and colleagues broaden the discussion yet further with their ecological framework, citing individual stories that show that each person is different and that it is not necessary (indeed it may not be useful) to have a ‘prescription’ for resilience. Sawyer and Allman then focus on mobility, emphasising that people live their lives in a ‘life-space’ which includes social and environmental resources and that mobility is not just about individual functional ability. The book concludes with Gergen and Gergen's fascinating postulate that the common conception of the lifecourse as one of getting ‘old’ and consisting of ‘decline’ is socially constructed and it is within our power to create many alternative visions of the ageing experience.
There are a few limitations to this book, which I hope will be addressed in future editions. While it is very scholarly and well researched, I would have appreciated more stories and illustrative examples, and more focused practical suggestions about the implications of the research. Also, much of the research is of middle-class, relatively affluent people in western societies. I would have liked more research into non-western cultures and marginalised and oppressed groups of older people, with at least tentative practical suggestions about how the theories of resilience described in the book could be used to develop resilience in these other groups of older adults.
In summary, this is an excellent accessible book which should appeal to a broad range of practitioners, researchers and policy makers interested in optimising quality of life in the later decades of life.