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The concepts of fragility and resilience are often used together to describe elderly people with reduced physical activity. While fragility, which develops with the aging of the body, is a biological syndrome of a decrease in the stressors response resulting from cumulative regression in many physiological systems, and age related a comprehensive assessment of the ability resistance to stress. In this regard, it is important to develop systems and scales for the identification groups of risk among the elderly. The complexity of the solution lies in the fact that the study of fragility and physical resilience is interdisciplinary, primarily related to the health and increase in the active life of older people. The review describes theories based on the mechanisms of physiological aging, among them the theory of a decrease in the ability to stress, in which stress-related to diseases. The cycles of the development of fragility and a decrease in physiological reserves are considered, and, as a consequence, a change in reactivity to stress, which leads to the development and progression of diseases. The article presents data on homeostatic dysregulation in the accumulation of cumulative deficiency and related changes in heart rate variability, which allows early diagnosis of stressors in the elderly. These data will be useful for the development and implementation of preventive measures aimed at improving the quality of life and resistance to stress factors in elderly and senile people.

The concept of human resilience was created to search for new approaches to improving the well-being of middle-aged, elderly and old people. Resilience is based on the physiological mechanisms of maintaining homeostasis and the ability of organs and tissues to regenerate. Identifying the correlation between environmental factors and the level of reactivity of the body is an important aspect in assessing viability. It contributes to an increase in human life expectancy. Age-related resilience is based on neurophysiological mechanisms of protective processes at different levels, including neural networks and epigenetic mechanisms regulating the expression of MANF, TIMP-2, adropin, irisin, CCL2, CCLR2, β2M genes. The study of medical, psychological, and social indicators of resilience will contribute to the development of new approaches to the correction of age-related pathology.