Physiologic complexity and aging: Implications for physical function and rehabilitation

The dynamics of most healthy physiological processes are complex, in that they are comprised of fluctuations with information-rich structure correlated over multiple temporospatial scales. Lipsitz and Goldberger (1992) first proposed that the aging process may be characterized by a progressive loss of physiologic complexity. We contend that this loss of complexity results in functional decline of the organism by diminishing the range of available, adaptive responses to the innumerable stressors of everyday life. From this relationship, it follows that rehabilitative interventions may be optimized by targeting the complex dynamics of human physiology, and by quantifying their effects using tools derived from complex systems theory. Here, we first discuss several caveats that one must consider when examining the functional and rehabilitative implications of physiologic complexity. We then review available evidence regarding the relationship between physiologic complexity and system functionality, as well as the potential for interventions to restore the complex dynamics that characterize healthy physiological function. (C) 2012 Elsevier Inc. All rights reserved.