Annual Stein Symposium Emphasizes Physical, Mental and Cognitive Resilience in Older Adults

The Sam and Rose Stein Institute for Research on Aging at University of California San Diego held its annual Stein Symposium on Healthy Aging this fall, bringing together 320 researchers, clinicians and community members to explore the role of resilience — the ability to adapt and thrive in the face of life’s challenges — in healthy aging. The event took place at UC San Diego Park & Market in downtown San Diego.

Experts from UC San Diego and several other institutions at the forefront of aging research discussed the latest scientific findings on how resilience contributes to multiple facets of health as we age.

Executive Director Danielle Glorioso said the institute focuses on resilience to empower older adults with tools to increase “healthspan”, the duration of time a person lives in good health, free from chronic diseases and disabilities.

Alison Moore, M.D., M.P.H., director of the Institute and professor and chief of the Division of Geriatrics, Gerontology and Palliative Care at UC San Diego School of Medicine and affiliate faculty at Qualcomm Institute, noted that the Stein Institute is focused on the emerging field of geroscience, which aims to uncover the root causes of conditions often associated with aging, such as diabetes, heart disease, cancer and Alzheimer’s disease so they can be prevented or disrupted, and investigate the drivers of healthy aging across biological, behavioral, social and environmental domains.

In his address to attendees, Anthony Molina, Ph.D., professor of medicine at UC San Diego School of Medicine and scientific director of the Institute, identified three domains of resilience that are key to healthy aging: resisting age‑related decline, adapting to changing physical abilities, and recovering from setbacks.

“Healthy aging isn't just about avoiding sickness or avoiding stress — that's not really a reasonable goal; healthy aging also refers to our ability to bounce back,” Molina said.

This year’s keynote speakers were Heather Whitson, M.D., a geriatrician, and director of the Duke Aging Center at Duke University, and John C. Newman, M.D., Ph.D., assistant professor at the Buck Institute for Research on Aging.

Both speakers emphasized that resilience is becoming increasingly measurable, and reflects the interplay of physical, cognitive and psychosocial health.

Recent scientific advances now make it possible to estimate a person’s biological age by studying multiple biomarkers for disease, such as inflammation, blood glucose and genes.

These measures capture the “pace of aging,” which predicts higher risk for age‑related diseases and can reveal pathological changes in the brain associated with Alzheimer’s disease or other neurodegenerative conditions before they become irreversible.

Measuring biological aging enables clinicians to detect frailty and illness early, identify more vulnerable individuals, test interventions that boost resilience and provide targeted therapies to improve outcomes. It also allows patients to prepare for upcoming surgeries or other procedures by making improvements to their physical, mental and nutritional health beforehand, lowering their risk of complications and reducing recovery time.

“Aging is biology," said Newman. “We can target its hallmarks to improve healthspan — that’s not science fiction any more.”

The symposium’s three panel discussions on physical, cognitive and mental health explored evidence-based strategies for boosting resilience, and older adult community members on each panel shared their own experiences with building resilience.

Physical health panel

The physical health panel, moderated by Maile Young Karris, M.D., associate clinical professor of medicine at UC San Diego School of Medicine, noted the importance of building physical resilience at any age, even after falls, cancer treatment or other major health issues. Evidence suggests that any level of physical activity—no matter how modest—helps accelerate healing and recovery.

In addition, recent advances in wearable technology now allow real‑time monitoring of health metrics and physical function, benefiting older adults and their health care providers.

The risk of falls increases as we age and they can negatively impact the healthspan of older adults, according to Theodore Chan, M.D, professor and chair of the Department of Emergency Medicine at UC San Diego School of Medicine.

The panelists recommended simple home‑based strength and balance exercises to make older adults more “fall‑proof,” and emphasized the value of accessing social support through community programs, group activities, or partner workouts for accountability and motivation.

Community‑level strategies, including building walkable neighborhoods, mixed‑use developments and accessible senior centers also create environments that encourage older adults to stay active, the panelists said.

Mental health panel

The mental health panel, moderated by Elizabeth W. Twamley, Ph.D., professor of psychiatry at UC San Diego School of Medicine, discussed strategies for building psychological resilience in later life — especially for older adults who may feel socially isolated. Psychological resilience is characterized by the ability to resist, adapt and recover after stress or traumatic experiences,  and to cultivate daily habits that support emotional well‑being, according to panelist Ellen Lee, M.D., professor in residence of psychiatry at UC San Diego School of Medicine. She also stressed the importance of seeking help when overwhelmed.

“How do you thrive and become something even better, stronger and more than what you were originally?” she said.

Sidney Zisook, M.D., professor emeritus of psychiatry at UC San Diego School of Medicine, noted that grief is a common experience for older adults, and can become a form of resilience when adapting to the loss of loved ones over time. He explained that acute grief — marked by intense pain, sleep disruption and appetite changes — can evolve into “integrated” grief, which builds resilience. Key steps include accepting the reality of loss, allowing and expressing emotions, cultivating new sources of joy, strengthening existing relationships and practicing self‑compassion and patience.

While grief never fully disappears, Zisook said moving through it deepens compassion, clarifies values and renews one’s appreciation for life and relationships.

Cognitive health panel

The cognitive health panel, moderated by Fadel Zeidan, Ph.D., professor of anesthesiology at UC San Diego School of Medicine and Endowed Professor of UC San Diego's Sanford Institute for Empathy and Compassion, explored resilience in the brain throughout one’s life. While many people assume that cognitive decline is an inevitable part of aging, research suggests otherwise, according to Erin Sundermann, Ph.D., associate adjunct professor of psychiatry at UC San Diego School of Medicine.

“We can't change our age or our genes, but we can certainly build resilience in the brain to help ward off age-related brain changes and dementia,” she said. Evidence suggests that even moderate activity has protective benefits. “Brisk walking for 150 minutes a week reduces dementia risk by 20 to 30%. Physical activity promotes blood flow to the brain, reduces risk of hypertension and diabetes, which are very strong risk factors for dementia, and it helps to relieve anxiety, depression and inflammation.”

Sundermann said social isolation is linked to smaller brain regions responsible for memory and thinking. Getting involved in one’s community, joining affinity groups, and taking up new hobbies can all be strategies for maintaining cognitive resilience. In addition, hearing loss is a risk factor for social isolation and dementia, and hearing aids can help.

Zeidan says mindfulness-based mental training has been shown to change the way older adults experience pain.

“It's not necessarily taking the pain away, it's just changing the relationship that you have with your pain,” he said. “You don't need years of training to reap the benefits, even one session can make you feel better.”

Raeanne Moore, Ph.D., professor of psychiatry at UC San Diego School of Medicine, discussed the potential of digital phenotyping — the use of smartphone and wearable technology to monitor movement, sleep patterns and other physiological data — to detect early risks for cognitive decline.

Laughter and learning

During lunch, symposium attendees enjoyed a performance by the Free Spirits Senior Improv Company, a comedy group for community members 60 years and older sponsored by the Osher Lifelong Learning Institute of UC San Diego.

The symposium also included a poster session featuring research on physical, mental health and cognitive health by UC San Diego students, trainees, and junior faculty.

“At UC San Diego, we're proud to be a leader in the science of healthy aging and longevity,” said John M. Carethers, M.D., Vice Chancellor for Health Sciences at UC San Diego. “The Stein Institute for Research on Aging has long been champions of understanding the strengths of aging and examining the drivers of resilience and longevity. We believe aging is something to understand, support and celebrate through science and connection.”

To contribute to the Stein Institute’s Invest in a Future of Healthy Aging fundraising campaign, visit healthyaging.ucsd.edu.