Focus on Biobehavioral Perspectives on Health in Late Life (Annual Review of Gerontology and Geriatrics, vol. 30) (review)

Over the past decade, we have not only witnessed an expansion of research dedicated to the aging population, but have also observed a shift from a unidimensional to a multidimensional approach to understanding health predictors and outcomes in older adults. Specifically, to understand variance in and contributors to both healthy and pathological aging, we must incorporate an interdisciplinary model that addresses biological, social, and behavioral factors as well as their interdependent associations with health in late life. Focus on Biobehavioral Perspectives on Health in Late Life presents a compendium of research aimed, from a biobehavioral standpoint, at understanding the etiology, precipitating factors, and course of health status in older adults.

The goal of presenting biobehavioral research is arduous. Whitfield, of Duke University, has attempted to apply Anderson’s (1998) five levels of analysis within the scope of biobehavioral health research: (a) social/environment, (b) behavioral/psychological, (c) organ system, (d) cellular, and (e) molecular. Although Whitfield accomplished this goal, the more ambitious goal of traversing these levels (i.e., interactions across the five levels) was not necessarily achieved. Nonetheless, this book provides a respectful summary of the biobehavioral work published up until 2009.

Focus on Biobehavioral Perspectives is clearly written and divided into three sections: Introduction (three chapters), Cells to Homeostatic Systems (five chapters), and Person to Society (six chapters). Appropriately, Whitfield begins by defining “biobehavioral” and outlining the importance of an interdisciplinary perspective in health research. Sarah Szanton and colleagues continue with a biobehavioral, “society-to-cell model” of resilience in older adults, which emphasizes that an individual’s potential for health resilience in late life is determined by changes at multiple levels, including the societal, community, individual, physiological, and cellular levels. The potential for resilience in late life is determined by earlier life experiences, which emphasizes the significance of researchers’ taking a biobehavioral lifespan perspective. Szanton and colleagues’ discussion prepares the reader for subsequent chapters that focus on correlates of health in late life at each of the aforementioned levels. Finally, Whitfield and colleagues end the Introduction by discussing methodological considerations for complex interdisciplinary systems. Of notable importance is their discussion on socioeconomic status and ethnic diversity, two significant factors that are highly interrelated yet commonly ignored or given low priority in health research.

In the book’s second section, Cells to Homeostatic Systems, Susan Motch and Roger McCarter (Pennsylvania State University) examine the role of oxidative stress as an aging mechanism as well as the role of potential defenses against oxidative damage, including nutrient intake, caloric restriction, and exercise. Although free radicals are considered agents of damage, the authors recognize that free radicals are also required for health maintenance. Despite the chapter’s thorough examination of the effects of exercise and caloric restriction on oxidative damage, the authors should have more cautiously interpreted data regarding the positive effects of caloric restriction and resveratrol on health, which require further investigation in humans (this is especially the case for resveratrol about which there have been recent news reports of fabricated and falsified data). Notably, and in line with the biobehavioral model, Motch and McCarter address the importance of genetics in determining the beneficial and adverse effects of calorie restriction on health as well as the underlying biochemical mechanisms involved in efficacy of caloric restriction on health outcomes.

Moving from the cellular level, Kathleen Welsh-Bohmer and colleagues (Duke University) outline genetic contributions to cognitive disorders, with a focus on modifiable targets that may prevent or slow the late-life progression of decline in cognitive function. The chapter, although insightful, would have benefited from a more in-depth discussion of gene-gene interaction effects in predicting change in cognitive function in late life.

Shari Waldstein (University of Maryland) and colleagues’ chapter on hypertension and neurocognitive function in late life highlights only positive findings in the literature; however, the authors do present the limitations of studies that focus...