Article

Psychological Resilience and Health Among Older Adults: A Comparison of Personal Resources

August 2020
The Journals of Gerontology Series B Psychological Sciences and Social Sciences 76(7)

Authors:

Florida State University

Objectives: Research on life course inequality and successful aging has sought to understand how events and challenges may lead to poor outcomes in later life for some individuals, while others fare well in the face of adversity. Among internalized resources, research suggests psychological resilience is protective in the face of challenges, but little is known about the predictive efficacy of this measure compared to other resources such as mastery. This paper examines connections between psychological resilience and later life health compared to other internalized resources. Method: Standardized associations between 4 resources (resilience, mastery, optimism, hopelessness) and 5 health outcomes were tested using short-term health transitions and longer term health trajectories in a structural equation modeling (SEM) framework using the Leave Behind Questionnaire (LBQ) and linked Health and Retirement Study (HRS) between 2006/2008 and 2014/2016 (N=11,050 to 12,823). Results: Psychological resilience had consistent and robust associations with health transitions and trajectories. Further, the effects of this resource were generally 4-10 times greater than for mastery, optimism, and hopelessness in combined models. Trajectory analyses replicate these findings and suggest the beneficial associations of resilience over time were persistent for some health outcomes, and cumulative for others. Discussion: The results suggest that psychological resilience is powerfully associated with health in later life, with substantially greater predictive efficacy than other commonly used resource measures. Future research should establish how this intrapersonal resource works alongside structural and interpersonal resources to promote and protect health and functioning in the face of challenges and adversity.

Psychological Resilience and Frailty Progression in Older Adults

Article

Full-text available

Nov 2024

Importance The association between psychological resilience (PR) and frailty progression in older adults is not fully understood. Objective To investigate the longitudinal associations between PR and its changes (ΔPR) with frailty progression among older adults. Design, Setting, and Participants Data were collected from a community-based prospective cohort study conducted in Shanghai from 2020 to 2023. Older adults aged 60 years and above were recruited at baseline and completed follow-up assessments. Statistical analysis was performed from May to July 2024. Exposures PR was assessed using the 25-item Connor-Davidson resilience scale (CD-RISC). ΔPR was calculated using the difference between 3-year follow-up and baseline CD-RISC scores. Multiple key covariates were included such as demographics, health behaviors, social participation, and chronic diseases. Main Outcomes and Measures Frailty was evaluated using the Chinese Frailty Screening Scale-10. Frailty progression was categorized into 3 groups (improvement, stability, and deterioration) by the difference assessment between 3-year follow-up and baseline. Results A total of 4033 participants were included in the study (mean [SD] age, 71.0 [6.1] years; 2257 [56.0%] women). Over a 3-year follow-up period, 1142 participants (28.3%) experienced an improvement in frailty, 1200 (29.8%) experienced stability, and 1691 (41.9%) exhibited deterioration. After controlling for confounding variables, a significant association was found between PR and future frailty, particularly when baseline frailty scores were at least 3 vs 2 or lower (β, −0.136 [95% CI, −0.214 to −0.057] vs −0.020 [-95% CI, −0.052 to 0.012]; P for interaction < .001). A similar association was observed between PR and frailty improvement (adjusted odds ratio [OR], 1.28 [95% CI, 1.05 to 1.57]). Furthermore, ΔPR displayed a significant association with frailty, exhibiting a nonlinear association that was stronger when ΔPR was less than 0 vs when ΔPR was greater than 0 (β,−0.186 [95% CI, −0.228 to −0.145] vs −0.068 [95% CI, −0.107 to −0.029]; P for nonlinear < .001). Similarly, ΔPR was significantly associated with frailty progression, indicating both improvement (adjusted OR, 1.30 [95% CI, 1.19 to 1.42]) and deterioration (adjusted OR, 0.74 [95% CI, 0.69 to 0.80]). These associations were more pronounced among older adults with higher levels of baseline frailty. Conclusions and relevance In this cohort study of community-dwelling older adults, a longitudinal association between PR and frailty progression was found. The results suggest that monitoring changes in PR can help forecast future frailty trajectories, particularly highlighting the need to support individuals facing declines in resilience. Targeted interventions that prioritize enhancing PR have potential to prevent and ameliorate frailty.

Longitudinal trajectories of psychological resilience and cognitive impairment among older adults: evidence from a national cohort study

Preprint

Sep 2024

Background The relationship between resilience trajectories and cognitive health is not well understood. This study aimed to identify subgroups of psychological resilience trajectories in a national sample of older adults and to examine the association with cognitive impairment over time. Methods This study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018, and 2,788 respondents were included in this prospective analysis. Using a group‐based trajectory modeling approach, we identified resilience trajectory groups within a 6-year period. Cox proportional hazards models were used to assess the relationship between the resilience trajectory groups and cognitive impairment. Results Three distinct trajectories of psychological resilience, including decreasing resilience group (n=131,7.1%), persistent middle resilience group (n=1,808, 58.1%), and persistent high resilience group (n=849, 34.8%). During the 6-year follow-up, compared to those with persistent high resilience, participants with persistent middle resilience (HR = 1.43, 95% CI = 1.14-1.79) and decreasing resilience (HR = 2.46, 95% CI = 1.76-3.43) remained consistent associated with a higher risk of cognitive impairment. Subgroup analysis showed that, the associations between resilience trajectories and cognitive impairment varied by lifestyle and health conditions. Conclusions Psychological resilience is a relatively stable trait among older adults in China, with most individuals maintaining a persistently high or middle level of resilience throughout the follow-up period; however, declining psychological resilience was significantly associated with the risk of cognitive impairment. Therefore, developing targeted interventions to strengthen psychological resilience in older adults is crucial for promoting cognitive health and successful aging, especially for those who have unhealthy lifestyles and with poorer health conditions.

Cyclical Migration in Alaska Native Elders and Its Impact on Elders’ Identity and Later Life Well-Being

Article

May 2023
J GERONTOL B-PSYCHOL

Objectives: This paper outlines the unique culturally driven cyclical migration of Alaska Native (AN) Elders, distinct from previously described migration patterns in that Elders spend extended time in more than one community. We describe this Indigenous cyclical migration of AN Elders and its influence on their identity and later life health and well-being. Methods: Interviews with 124 AN Elders were conducted across five regions of Alaska: Bristol Bay, Interior, Norton Sound, Aleutian Pribilof Islands, and Southcentral. Within this sample, 87 participants engaged in cyclical migration. Thematic analysis was employed to identify themes related to Elders' cyclical migration between rural and urban communities and the impact on their identity and later life health and well-being. Results: We identified two distinct patterns of Indigenous cyclical migration-Elders living primarily in rural communities migrating to urban communities and Elders living primarily in urban communities migrating to rural communities. Elders engaged in these two patterns of cyclical migration to maintain cultural practices, access social and healthcare services to maintain their physical health and well-being, and continue their community roles contributing to their AN Elder identity. Discussion: This study builds upon existing migration theories by introducing a cyclical pattern uniquely driven by AN identity, culture, and traditional practices. Findings illustrate how AN communities can support Elders who experience cyclical migration patterns to ensure they age successfully in both locations. Future research should explore cyclical migration patterns among other Indigenous populations with migration histories.

Resiliency Among Women’s Health Initiative Women Aged 80 and Older by Race, Ethnicity, and Neighborhood Socioeconomic Status

Article

Mar 2023
J GERONTOL B-PSYCHOL

Objectives: A comprehensive examination of resilience by race, ethnicity, and neighborhood socioeconomic status (NSES) among women aged ≥80 is needed, given the aging of the US population, increasing longevity, and growing racial and ethnic diversity. Methods: Participants were women aged ≥80 enrolled in the Women's Health Initiative (WHI). Resilience was assessed with a modified version of the Brief Resilience Scale. Descriptive statistics and multiple linear regression examined the association of demographic, health, and psychosocial variables with resilience by race, ethnicity, and NSES. Results: Participants (n=29,367, median age=84.3) were White (91.4%), Black (3.7%), Hispanic (1.9%), and Asian (1.7%) women. There were no significant differences by race and ethnicity on mean resiliency scores (p=0.06). Significant differences by NSES were observed regarding mean resiliency scores between those with low NSES (3.94±0.83, out of 5) and high NSES (4.00±0.81). Older age, higher education, higher self-rated health, lower stress, and living alone were significant positive correlates of resilience in the sample. Social support was correlated with resilience among White, Black, and Asian women, but not for Hispanic women. Depression was a significant correlate of lower resilience, except among Asian women. Living alone, smoking, and spirituality were significantly associated with higher resilience among women with moderate NSES. Discussion: Multiple factors were associated with resilience among women aged ≥80 in the WHI. Despite some differing correlates of resilience by race, ethnicity, and NSES, there were many similarities. These results may aid in the design of resilience interventions for the growing, increasingly diverse population of older women.

The Relationship between Body Image, Self-concept, Resilience and Successful Aging predictors among Academic Emeritus

Article

Full-text available

Dec 2024

Background: All individuals without exception will go through the aging process. Invariably, this process comes with a variety of losses, starting from physical to functional, psychological, and social loses. These losses can stimulate dissatisfaction with one's body image, lowering self-esteem and disturb self-concept as whole. So, it is important for older people to promote resilience to facilitate successful aging. Aim: to identify the relationship between body image, self-concept and resilience of academic emeritus and successful aging. Research design: a descriptive correlational research design was used.

The Relationship between Body Image, Self-concept, Resilience and Successful Aging predictors among Academic Emeritus.

Article

Dec 2024

Increasing stress resilience in older adults through a 6-week prevention program: effects on coping strategies, anxiety symptoms, and cortisol levels

Article

Full-text available

Jan 2025

Introduction As people age, chronic stress, resulting in prolonged or repeated activation of the hypothalamic–pituitary–adrenal (HPA) axis, has been associated with long-term adverse health outcomes. Coping strategies and social support have been recognized as contributing to resilience to stress in older adults. Few studies have evaluated stress management training (SMT) interventions based on psychoneuroendocrinology that were designed to be delivered to healthy older adults in community settings. Methods In this study, a total of 170 older adults (mean age = 76.07, SD = 7.67) participated in a cluster-randomized trial designed to compare the delivery of an SMT intervention with a waitlist condition. Results The effect of SMT on coping strategies, stress, anxiety, and depression was measured 3 weeks and 3 months after the intervention. In addition, we tested the effect on basal cortisol secretion over 2 days from saliva samples upon awakening and the total diurnal cortisol output [area under the curve with respect to ground (AUCg)]. Results from repeated measures analyses of variance showed that participants who received the intervention demonstrated a significant increase in problem-solving coping strategies and a decrease in anxiety scores 3 weeks after the intervention compared to the waitlist group. STM participants also demonstrated lower cortisol levels on the AUCg index. At the 3-month follow-up, gains were maintained only on the AUCg index. Discussion This type of brief preventive program could reduce basal cortisol levels in older adults, which may be an important protective factor against health outcomes associated with chronic HPA activation. Our results provide sufficient evidence to warrant further research to improve the effectiveness of O’stress in different settings.

Psychosocial resilience surrounding age-typical losses among older adults in Sweden: group-based trajectories over a 25-year-period

Article

Full-text available

Oct 2024

Introduction Resilience is an important but often neglected aspect of healthy or successful aging. This study used a new approach for modelling psychosocial resilience to investigate responses when faced with age-typical losses. Rather than viewing resilience as a trait, we modelled trajectories of life satisfaction when faced with partner or functional loss in later life to identify resilient trajectories. Then, we examined characteristics associated with belonging to resilient trajectories. Method We analyzed longitudinal data from the individually linked Swedish LNU and SWEOLD surveys collected repeatedly between 1991 and 2021 (N = 450). A group-based trajectory modelling technique was used to obtain trajectories of life satisfaction over time, centered around the first identified loss. Identified losses (widowhood, loss of mobility and loss of vision), occurred between ages 60 and 98. Results Four trajectories of life satisfaction surrounding loss were identified, labelled Declining (46%), Non-recovering (24%), Recovering (16%), and Bouncing back (14%). The latter two were categorized as resilient. Individuals in resilient trajectories were more likely to be younger, engaged more with their friends after the loss, reported fewer mental health problems both before and after the loss, and had a higher sense of control before the loss. Discussion Several interesting patterns of long-term change in life satisfaction were found in response to loss. Contrasting earlier findings, only about one-third of the sample was categorized as resilient. The two resilient trajectories were characterized by either quick adaptation or a slower adaptive process. Increasing or maintaining social networks, particularly friendships, after an age-typical loss may promote resilience.

Perceived Health Status Predicts Resilience after Hip Fracture in Older People

Article

Full-text available

Oct 2024

Background and Objectives: Perceived health status (PHS) is associated with various health outcomes in older adults, but its relationship with resilience in the context of events with a major impact on functional status (FS), such as hip fracture, has not been explored. Our objective was to evaluate whether older adults who report good PHS before a hip fracture have a higher probability of returning to their baseline physical performance (PP) and personal independence. Materials and Methods: We analyzed data from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe (SHARE) study, enrolling patients ≥ 65 years who experienced a hip fracture between these two waves. As study outcomes, we analyzed changes in PP and functional abilities (FAs). Results: We included 149 participants with a mean age of 75.7 years (SD: 6.5); women comprised 66%. The incidence of loss of PP was 51.7% among participants with good PHS and 59.6% among those with poor PHS. FA worsened in 40% of participants with good PHS and 58.4% in those with poor PHS. Relative risk (RR) for loss of FA in people with good PHS was 0.68 (95% CI: 0.48–0.98), which did not change after an adjustment for age, gender, baseline FA, depression, number of comorbidities, education, income, and social support, despite it not reaching statistical significance. After adjustment, the risk of worsening PP in participants with good PHS was reduced by 34% (95% CI: 0.41–1.06). Conclusions: A simple question on PHS may predict the resilience of older adults after an acute stressor. A systematic evaluation of PHS can help identify patients with a higher probability of regaining function after a hip fracture and thus provide useful information for resource allocation.

Resilience in Older People: A Concept Analysis

Article

Full-text available

Sep 2023

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in older people. However, further clarification of the concept of resilience for this population is required, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in older people to establish the elements that refer to the nursing outcome. Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in older people. (3) Methods: Concept analysis using Beth Rodgers’ evolutionary model. The attributes, antecedents, consequents, and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS, and Embase databases. A total of 2431 citations have been identified, and 110 studies were included. (4) Results: The concept of “resilience in older people” is composed of two attributes, available resources and positive behaviors, and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in older people provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.

Cross-Lagged Associations Between Physical Activity, Self-Rated Health, and Psychological Resilience Among Older American Adults: A 3-Wave Study

Article

Apr 2023

Sunwoo Lee

The current study examined the reciprocal association between psychological resilience, physical activity, and self-rated health in older America adults. A 3-wave cross-lagged panel design was employed using data sampled from the Health and Retirement Study 2010, 2014, and 2018. In total, 8380 older adults, age ranged between 56 and 95 years at the baseline (mean age = 68.06, SD = 7.77), were analyzed. Using structural equation modeling, standardized path coefficients were estimated to determine the relationship between physical activity, self-rated health, and psychological resilience across 2 follow-up points. Cross-lagged analysis revealed that higher levels of physical activity at T1 and T2 were significantly associated with higher levels of self-rated health at T2 and T3, respectively. Self-rated health at T1 and T2 were significantly associated with physical activity at T2 and T3, respectively. Self-rated health and psychological resilience were positively related to one another at each time point. However, relationship between physical activity and psychological resilience was complex across time. Study findings support reciprocal prospective relationship between physical activity and self-rated health and the relationship between self-rated health and psychological resilience.

Роль персональных психологических ресурсов в объяснении возрастных неравенств здоровья в странах Европы

Article

Full-text available

Sep 2022

В статье рассматриваются ухудшение здоровья с возрастом и возможности его объяснения, помимо естественных процессов старения организма, влиянием нарастающего дефицита психологических ресурсов личности, необходимых для преодоления жизненных тягот и вызываемых ими стрессовых состояний. С помощью регрессионного анализа, позволяющего оценивать посреднические эффекты, исследуются данные массовых опросов Европейского социального исследования (ESS Round 6) для двух групп стран, отличающихся слабым и сильным социальным государством, а также проводится двухуровневое моделирование с использованием сведений о 27 странах Европы, позволяющее выявить зависимости непрямых эффектов от контекстуального модератора — государственных расходов на здравоохранение. Результаты показывают, что во всех странах на поддержание здоровья влияют психологические ресурсы. Они позволяют отчасти объяснить возрастные различия самочувствия — играют роль медиатора между возрастной структурой и связанными с ней неравенствами в здоровье: с возрастом люди утрачивают психологические качества, необходимые для преодоления жизненных трудностей, и это усугубляет проблемы со здоровьем у пожилых людей. Особенно заметны такие медиативные эффекты в странах со слабым социальным государством — при восточноевропейском режиме обеспечения социальных гарантий или невысоких расходах государства на здравоохранение. В этих странах представителям уязвимых слоев, включая людей в старших возрастах, труднее сохранить психологическую уверенность в собственных силах и возможности изменений жизни к лучшему, поскольку им во многом приходится рассчитывать только на себя. Социально-демократический режим, предоставляя широкие социальные гарантии и равный доступ к качественным медицинским услугам, создает благоприятные условия для сохранения психологических свойств, препятствующих физиологическому старению и утрате здоровья. В статье обсуждаются медиации, связанные с такими качествами, как автономия и контроль, оптимизм, оценка своего «я», устойчивость и состоятельность.

Gender and Psychosocial Differences in Psychological Resilience among a Community of Older Adults during the COVID-19 Pandemic

Article

Full-text available

Aug 2022

The study aimed at exploring gender and additional sociodemographic differences in psychological resilience, as well as the association between resilience and psychological distress in older adults, during the first lockdown in Italy, due to the COVID-19 pandemic. Participants attended an online survey during the first lockdown in May 2020. Psychological distress was assessed through the Depression Anxiety Stress Scale-21, the Resilience Scale (RS) was administered to evaluate psychological resilience, and sociodemographic variables were also collected. The study involved 108 community older adults (mean age 70.02 ± 3.5 years). Comparisons revealed that women reported significantly lower total scores of RS (p = 0.027), as well as lower levels of resilience-related domains, namely Meaningfulness (p = 0.049), Self-Reliance (p = 0.011), Perseverance (p = 0.035), and Existential Aloneness (p = 0.014), compared to men. Significantly higher RS scores were found in older adults being involved in a relationship, compared to those not involved in relationships (p = 0.026), and in older adults with children (p = 0.015), compared to those without offspring, suggesting the importance for older adults of not dealing alone with such a dramatic and stressful event, such as the pandemic. Negative correlations were found between psychological resilience and stress, depression, and anxiety. Linear regressions revealed that lower RS total scores, as well as lower scores in the majority of the RS scales, were associated with greater levels of stress, greater levels of anxiety, and greater levels of depressive symptoms. This study suggested that older women might appear more vulnerable in facing the pandemic, compared to men; having not lived alone through the lockdown period might also be considered as a factor of resilience for older adults.

ANATOLIAN CURRENT MEDICAL Original Article Does greater richness of experience lead to greater happiness in older adults?

Article

Full-text available

Jan 2025

Zeynep Gümüş

Aims: The happiness during old age years is closely linked to psychosocial factors such as richness of experience. Richness of experience refers to the level of meaning and fulfillment in individuals' lives through various activities and experiences. This research focused on exploring how the richness of experience is related to the happiness in older adults. In addition, the role of various demographic and psychosocial variables in shaping this relationship were examined. Methods: The study sample consisted of 179 older adults. 64.2% of the participants were female and 35.8% were male. The participants were administered the psychologically rich life questionnaire, and the psychological well-being in the elderly scale as well as a sociodemographic form. Simple Linear Regression was used to analyze the predictive power of richness of experiences, and pearson correlation analysis was conducted to assess the strength of the relationships between richness of experiences and psychological well-being. Independent Groups t-test and ANOVA were applied to explore if there is a difference on the score based on the sociodemographic differences. Results: The results of this study indicated a significant positive correlation between a psychologically rich life and psychological well-being in older adults. According to regression analysis, psychologically rich life was found to be a strong predictor of psychological well-being and explained 57% of the variance. Education level and income level were found to significantly affect psychologically rich life and psychological well-being levels such that university graduates and high-income group received the highest scores. Participants without a chronic disease were found to have significantly higher scores on psychological well-being and psychological rich life. No significant differences were found in terms of other sociodemographic variables such as gender, marital status and having children. Conclusion: These findings suggest that richness of experiences can be an important factor that improves the quality of life of older adults and the value of diversity of experiences for psychological well-being.

Resiliência na interação entre fatores de risco e de proteção no envelhecimentoResilience in the interaction between risk and protective factors in agingResiliencia em la interacción entre factores de riesgo y protección em el envejecimiento: um estudo transversala crosssectional studyum estudio transversal

Article

Full-text available

Nov 2024

Objetivou-se avaliar a relação da resiliência e variáveis demográficas (idade, sexo, estado civil, religiosidade), com fatores de risco (eventos de vida, estresse, depressão) e de proteção (apoio social, esperança) no envelhecimento. Foram utilizados os seguintes instrumentos: Questionário Sociodemográfico, Inventário de Eventos Estressantes, Escala de Depressão Geriátrica, Escala de Resiliência, Escala de Esperança de Herth, Inventário de Rede de Suporte Social. Participaram 508 idosos com média de 71,16 anos. Os índices de resiliência, de esperança e de apoio social foram satisfatórios. Destacaram-se os eventos que afetam o bem-estar pessoal e 23,6% dos idosos apresentaram sintomatologia depressiva. A idade se correlacionou negativamente com a resiliência e a esperança. O teste de regressão linear múltipla resultou em um modelo no qual 22% do índice de resiliência foram explicados pelas variáveis esperança e depressão. Idosos mais longevos indicaram aumento de agravos à saúde mental; assim, práticas de promoção da resiliência devem ser privilegiadas com esse grupo.

Death Anxiety and Resilience in Older Adults: The Moderating Role of Attachment Patterns

Article

Full-text available

Nov 2024

Yoav S Bergman

The unique human awareness of the fact that life is finite, and that death is unavoidable has been shown to elicit negative psychological consequences across the life cycle. However, research has demonstrated that the ability to seek, maintain, and gain comfort from close relationships mitigates the adverse psychological effects of death awareness/anxiety. Moreover, relatively little is known about how death anxiety and social relationships in old age are associated with resilience, an important personal protective factor for dealing with general and age-related difficulties. Accordingly, the current work examined the links between death anxiety and resilience in older adults and explored the potential moderating role of attachment patterns for this link. Data were collected from 369 older Israeli adults (Mage = 73.15, SD = 6.31, range = 60–94), who completed scales examining death anxiety, attachment patterns, and resilience, as well as sociodemographic scales. The results demonstrated that death anxiety, attachment anxiety, and attachment avoidance were associated with reduced resilience. Moreover, the death anxiety-resilience link was not significant for individuals reporting high or low levels of both attachment anxiety and avoidance. The findings are discussed through the prism of Terror Management Theory, and practical implications are suggested.

Illness uncertainty, resilience, and perceived social support among patients with moyamoya disease: a cross-sectional study

Article

Full-text available

Jul 2024

Objective The present study aims to investigate the levels of illness uncertainty in patients with moyamoya disease and to determine the association of socio-demographic characteristics, perceived social support and resilience with illness uncertainty in patients with moyamoya disease. Method A cross-sectional survey using convenience sampling was conducted in two hospitals in China from August to December 2023. A socio-demographic characteristics questionnaire, the Chinese versions of Mishel’s Unsurety in Disease Scale (MUIS), the Chinese version of Connor-Davidson Resilience Scale (CD-RISC), and the Chinese version of Multidimensional Scale of Perceived Social Support (MSPSS) were used to perform this research. The collected data were analyzed using SPSS 24.0 statistical software. The t-test, one-way analysis of variance (ANOVA), pearson correlation analysis and hierarchical regression analysis were used to identify associated factors. Result A total of 263 patients with moyamoya disease were recruited in this survey. The score of illness uncertainty was at a moderate level of (100.03 ± 18.59). The present study identified a negative correlation between illness uncertainty with resilience perceived social support. Hierarchical regression analysis showed that gender, occupation, education level, resilience and perceived social support were the related factors of illness uncertainty. Conclusion Patients with moyamoya disease experienced moderate disease uncertainty on average, which was related to gender, occupation, education level, resilience and perceived social support. Future research is needed to better explore the complex relationships between illness uncertainty, resilience, and perceived social support with different types of moyamoya disease using longitudinal research.

Which personal and social resources help adolescents to recover from negative affect in daily life? An experience sampling study

Article

Full-text available

Nov 2024
J Child Adolesc Ment Health

Background: Reducing anxiety and depression of adolescents is a global health priority. Personal and social resources (e.g., hobbies, socializing) may reduce distress. Yet, there is insufficient understanding of how adolescents use such resources to reduce distress. Objective: To identify resources that reduced distress in the everyday lives of adolescents, and whether resource use differed according to symptoms of anxiety and depression. Methods: The experience sampling method was used, a longitudinal method requiring participants to report on context and mood at randomly selected moments across a week. 5558 reports were contributed by 151 adolescents, including 90 with symptoms of anxiety and/or depression. The study was conducted in the poorest neighbourhoods of Bogotá, Buenos Aires and Lima. Results: Multi-level modelling indicated that using resources was significantly associated with less nervousness and sadness. Adolescents with symptoms were less likely to use some resources (e.g., sport). Cross-level interactions showed the efficacy of resources differed according to severity of symptomatology. For adolescents with symptoms, some resources (e.g., peer support) improved mood, while others (e.g., music listening) did not. Discussion: Personal and social resources are important for reducing distress in the everyday life of adolescents, giving insight for potential interventions to help mitigate symptoms of anxiety and depression before escalation. Further research could assess the quality of experiences (e.g., appraisal) to deepen understanding of how engagement promotes resilience. Conclusions: Care must be taken when recommending resource use, since some forms (e.g., music listening) may be unhelpful to adolescents with symptoms of anxiety and depression.

Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains

Article

Full-text available

May 2024
Int J Environ Res Publ Health

This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.

Meaning in Late Life: A Scoping Review

Article

Full-text available

Feb 2024

Throughout the years some scholars have emphasised that developmental changes might influence the experience of meaning in life (MIL), especially in the case of older adults. However, so far, it is unclear whether researchers implement this developmental perspective when conceptualising MIL in late life. This scoping review aims to get insight in the developmental focus on conceptualising MIL in late life (adults aged 70 or older). A systematic literature search was performed using 7 databases (MEDLINE, Web of Science Core Collections, CINAHL, ProQuest Psychology, OSF Preprints, The Philosopher’s Index and AnthroSource) yielding 25 articles meeting the inclusion criteria. While most included articles solely described a general conceptualisation of MIL regardless of life stage, 3 studies mentioned a MIL conceptualisation adapted to older adults. These adapted conceptualisations shed light on components potentially distinctive for MIL in older adults, such as fulfilled purpose, ability to reconcile the past, continuation and felt coherence, beside the components currently included in general contemporary MIL conceptualisations, such as the components of the tripartite view on MIL. Largely, except of these 3 studies, most studies in this review did, thus, not include a developmental perspective. However, 10 studies referred to specific developmental aspects, such as time, past and expected changes in MIL in late life without implementing these developmental aspects to their conceptualisation of MIL. Consequently, the findings of this review suggest the importance of adapting a more explicit developmental perspective when conceptualising MIL in late life.

Self-efficacy and Optimism in frail elderly men without functional disability attending geriatric outpatient clinic in Mansoura university: a case-control study.

Preprint

Full-text available

Aug 2023

Doaa Ageez

Background Psychological frailty including cognitive, mood, and motivational components has a major impact on the well- being of frail elderly. Therefore, there is an increasing scientific interest in studying different domains of psychological frailty. Unfortunately, the psychological components of frailty are not completely evaluated and currently there is no consensus regarding appropriate intervention. This study aimed to evaluate self-efficacy and optimism in frail elderly without functional disability. This case-control study was conducted between August 2022 and March 2023, and included 70 elderly male community dwelling participants aged ≥ 60 years. The participants were divided into 2 groups: frail and non-frail defined by AVILA modification of Fried criteria. Self-efficacy scale (SES) and Revised-Life orientation test (R-LOT) were applied for all participants. Results Those with physical frailty had lower self-efficacy and optimism scores. R-LOT and SES had moderate diagnostic accuracy in predicting frailty; AUC for both tools were 0.75 and 0.71, respectively. Conclusions Psychological determinants of frailty are as equally important to be addressed as factors affecting physical frailty. self-efficacy and optimism are both affected in frail elderly. The Self-efficacy scale (SES) and the Revised-Life orientation test (R-LOT) should be applied as a measure of psychological resilience during comprehensive assessment of physical frailty to improve overall well-being and resilience among frail elderly.

Nutraceuticals and their role in promoting musculoskeletal healthy aging

Article

Full-text available

Dec 2022

Tariq A. Alalwan

Background: Aging is a complex and gradual biological process that represents the major risk factor with respect to the development of chronic degenerative diseases, often associated with disability. Diet and nutrition, coupled with proper physical activity have a significant impact on the health status of the elderly with a decreased risk of disease being indicative of successful aging. Musculoskeletal conditions such as osteoporosis and sarcopenia are the most frequently reported disorders among the elderly community. Methods: This study presents a systematic review of the literature on the potential benefits of several nutraceuticals in promoting healthy aging and in reducing the risk of chronic diseases in elderly individuals. Results: Dietary components including vitamins (vitamin C, B vitamin and vitamin K) flavonoids (e.g., quercetin, anthocyanins, and isoflavones), minerals (e.g., magnesium, zinc and potassium) and other nutrients such phytoestrogens, amino acids, and omega-3 fatty acids help in slowing the aging process, which ultimately results in increased lifespan and longevity. Conclusions: This paper highlights the key nutrients and phytochemicals of nutraceutical importance for the healthy aging of the elderly population. Although the scientific literature provides evidences of therapeutic effectiveness of nutraceuticals, more in-depth clinical investigations are needed.

The Mediation Chain Effect of Cognitive Crafting and Personal Resources on the Relationship between Role Ambiguity and Dentists’ Emotional Exhaustion

Article

Full-text available

Dec 2022
Int J Environ Res Publ Health

Based on Job Demands-Resources (JD-R), Conservation of Resources (COR) and self-regulation theories integration, this study investigated the association between role ambiguity and emotional exhaustion among 191 Romanian dentists, as well as the chain mediating role of cognitive crafting and three personal resources (resilience, optimism, and self-efficacy). Three conceptual models which included, separately, the three personal resources were proposed. PROCESS macros were used to verify the hypotheses related to the testing of the path mediation models. The results indicated that role ambiguity was directly and positively associated with dentists’ burnout. More importantly, the sequential indirect effect of role ambiguity on burnout via mediators in chains (cognitive crafting and resilience for the first model; cognitive crafting and optimism for the second model; cognitive crafting and self-efficacy for the third model) was significant. The findings provide a direction for dentists’ health intervention because it reveals how the negative impact of role ambiguity on emotional exhaustion increasing can be buffered by the cumulative effect of cognitive crafting and different personal resources, as a result of their chain reinforcement.

Dependency-associated individual, family, community, and social factors from a resilience framework among elderly people

Article

Full-text available

Sep 2022
CURR PSYCHOL

Dependency is a common personality disorder among elderly people, and there is currently no good evidence to recommend an intervention strategy for this disorder. This study aimed to assess the risk factors of dependency on the basis of a social ecological model. This is a community-based cross-sectional study. A total of 1276 participants aged ≥ 60 years were selected through a complex multistage sampling design from 27 locations in China and found eligible to participate in the study. All data were collected using questionnaires by face-to-face interviews. Multiple linear regression analysis was used to identify the association between dependency and related risk factors. Logistic regression analysis was conducted to assess the protective factors of dependency among individuals with high risk factors of dependency. The results of multiple linear regression analysis showed that the individual, family, community, and social factors were significantly associated with dependency. Logistic regression analysis showed that good social connection and social support were the most important protective factors for individuals with a high risk of dependency. We identify that dependency is associated with protection and risk factors from the individual, family, community, and social factors among elderly individuals. Based on resilience theory, our results suggest that using a social ecological model to assess the risk factors of dependency may be an effective way to develop intervention strategies of dependency among older people.

Pandemic Stories: The Voices of Older Adults

Article

May 2022

To document the reactions and experiences of older persons during the COVID-19 pandemic, we have conducted a qualitative study of 25 older adults (50 years of age and older) throughout the pandemic, using serial interviewing methods. This analysis reports on the data collected from the first two rounds of interviews – one conducted in the summer of 2020 and one conducted in the fall of 2020. Our thematic analysis found eight major themes: thoughts on the dangers of the pandemic, how the virus has changed daily life (including social life), health care during COVID (being a caregiver, losing a loved one, seeking health care), missing spontaneity and dealing with existential dread, the growing frustration, seeking connection through civic participation, adaptation and resilience, and the social ills that the pandemic has revealed. These stories describe both loneliness and connection, hope coupled with disappointment, but overwhelmingly, an insight into what the pandemic has shown us about the social ills that it has revealed.

Resilient Coping During The Covid-19 Pandemic: A Cross-Sectional Study of Unemployed and Employed People in Nigeria

Article

Full-text available

Mar 2022

Limited quantitative data exist on resilient coping among the unemployed and employed people during the COVID-19 pandemic. This study examined resilient coping during the COVID-19 pandemic in Nigeria. A cross-sectional research design was utilized via social media. Two hundred and eighty-two participants (age range = 18-62 years) were recruited using a snowball sampling technique. Participants filled out a standardized questionnaire comprising a demographic section and a brief resilient coping scale. Data were analyzed using the IBM SPSS Statistics version 25.0. Statistical significance was accepted at p < .05. The employed group scored significantly higher on resilient coping than the unemployed group (t (280) = 4.08, p <.01). Age had no significant effect (F (1,279) = 3.237; p>.05; np2 = .012) on resilient coping. Employment status had a significant effect (F (1,279) = 7.549; p<.01; np2 = .027) on resilient coping. Employment status had a significant effect on resilient coping by 2.7%. However, there was no significant interaction effect of age and employment status on resilient coping (F (1,279) = 3.137; p>.05). Male participants scored significantly higher on resilient coping than female participants (t (274) = 3.15, p <.01). The authors recommend that health professionals such as clinical psychologists and other concerned bodies should provide targeted psychosocial support interventions for the unemployed group and females in Nigeria during the COVID-19 pandemic.

Psychological Resilience, Cognitive Function, and Physical Activity: a Longitudinal Mediation Study

Article

Feb 2025
AM J GERIAT PSYCHIAT

Trajectories of Resilience-Related Traits and Their Impact on Health Outcomes in Schizophrenia: Results From a 4-Year Longitudinal Study

Article

Jan 2025

Background and Hypothesis For the rapidly growing population of older people living with schizophrenia (PLWS), psychological resilience, or the capacity to adapt to adversity, is an understudied target for improving health. Little is known about resilience and its longitudinal impact on outcomes among PLWS. This study assesses trajectories of resilience-related traits in PLWS and a nonpsychiatric comparison group (NCs) and longitudinal interactions between resilience and health. Study Design This sample included 166 PLWS and 155 NCs (mean age 48 years, 52% women), with a 4.1-year mean follow-up time. The groups were comparable in age, sex, and follow-up time. We assessed resilience-related traits, physical well-being, obesity, hyperglycemia, positive symptoms, and negative symptoms. We conducted linear mixed-effects models to examine linear trends over time and continuous-time structural equation models (CTSEM) to assess the longitudinal relationships (cross-lagged effects between resilience and health). Study Results People living with schizophrenia had lower resilience levels, compared with NCs. While resilience was stable over time for White individuals, younger non-White individuals with less education had increases in resilience over time. We found bidirectional 1-year cross-lagged effects of resilience with physical well-being and obesity, but not with hyperglycemia. Among PLWS, there were 1-year cross-lagged effects of resilience with both positive symptoms and negative symptoms. Conclusions These findings highlight the importance of resilience and its link to physical and mental health over time. Resilience may be a key protective factor in aging among PLWS, and the potential to improve resilience is an important and understudied approach for improving outcomes for older PLWS.

Longitudinal Associations Between Psychological Resilience and Cognitive Function: Evidence From the U.S. Health and Retirement Study

Article

Dec 2024
J GERONTOL B-PSYCHOL

Objective Reductions in psychological resilience and declining cognition are common among older adults. Understanding the longitudinal association between them could be beneficial for interventions that focus on age-related cognitive and psychological health. In this study, we evaluated the longitudinal associations between cognition and psychological resilience over time in a nationally representative sample of US older adults. Method A total of 9,075 respondents aged 65 and above from 2006-2020 Health and Retirement Study (HRS) were included in the current study. Cognition was measured through a modified 35-point Telephone Interview Cognitive Screen (TICS), and psychological resilience in the HRS was calculated using a previously established simplified resilience score. Bivariate latent growth modeling was used to examine the parallel association between psychological resilience and cognitive function over a period of up to 12 years. Results Positive correlations existed between the intercepts (r=0.20, SE=0.07, p<.001) as well as the slopes (r=0.36, SE=0.03, p<.001) for psychological resilience and cognition. The initial level of cognition positively predicted the slope of psychological resilience (β=0.16, SE=0.01, p<0.001), whereas a somewhat less robust effect was found for the slope of cognition and the initial level of psychological resilience (β=0.10, SE=0.03, p<0.001), after controlling all other covariates. Discussion In a population-based sample of US older adults, cognition and psychological resilience could mutually reinforce one another. Clinicians and policy makers may consider recommending tasks associated with improving cognitive function for interventions to bolster psychological resilience among older adults.

A qualitative exploration of the lives lived by Irish centenarians

Article

Aug 2024

Examining the contribution of personal and conditional resources to psychological wellbeing among parents of children with autism

Article

Sep 2024

Few would dispute that caring for a child with autism can be a positive and rewarding experience. However, it is often the case that parents (or guardians) of children with autism also experience lower psychological wellbeing and heightened psychological distress. In the present study, we harness Conservation of Resources theory, to examine the relative contribution of personal resources (parental self-efficacy and resilient coping) and conditional resources (perceived social support and family communication). A sample of 90 parents of children with autism were surveyed for their personal and conditional resources as well as their psychological wellbeing using measures of life satisfaction and psychological distress. Multiple regression analyses revealed that family communication and perceived social support were significant predictors of life satisfaction, while perceived social support and parental self-efficacy (unexpected direction) were significant predictors of psychological distress. The findings underscore the importance of conditional resources (and perceived social support in particular), for parents of children with autism and it is argued that interventions might focus more on socially supporting families to help promote their psychological wellbeing and reduce psychological distress.

The Association Between Frailty, Quality of Life and Resilience in Community-dwelling Retirement Village Residents

Article

Sep 2024

Role of subjective well-being and resilience in the relationship between hopelessness and suicidal ideation among older adults with moderate to severe ADL limitations in Chinese nursing homes

Article

Aug 2024

Resilience and successful aging: A systematic review and meta-analysis

Article

Full-text available

Jun 2024

Life Chances, Subjective Perceptions, and Healthy Lifestyles in Older Adults: Longitudinal Evidence From China

Article

Jun 2024
J GERONTOL B-PSYCHOL

Objectives Previous studies and theories show that healthy lifestyles are affected by life chances and subjective perceptions. However, it remains unclear how older adults change between different lifestyle profiles as they age. We proposed the healthy lifestyle duality framework and tested it among older Chinese adults using a longitudinal design. Methods Data were obtained from four Chinese Longitudinal Healthy Longevity Surveys conducted between 2008 and 2018 (N = 31,445). Latent transition analysis (LTA) and hierarchical multinomial growth curve (HMGC) models were performed to investigate healthy lifestyle profiles and their associations with life chances and subjective perceptions over time. Results Four distinct healthy lifestyle profiles were identified: healthy, risky, low-standard, and mixed groups, and their changes show path dependency. Across ten years, the proportion of the healthy group ranged from 11.16% to 16.97%. Both life chances and subjective perceptions were longitudinally associated with healthy lifestyles, with age and cohort effects observed. Discussion Our findings support the healthy lifestyle duality framework and reveal that life chances and subjective perceptions influence lifestyle changes over time. Public health policies and health intervention programs should adapt to the specific needs of different age groups and generations.

The Impact of Positive Self-Perceptions of Aging on Subjective Well-Being through the Mediation of Psychological Resilience among Community-Dwelling Older Adults during COVID-19 in Taiwan

Article

Full-text available

Apr 2024
HEALTH SOC CARE COMM

During the COVID-19 pandemic, the well-being of older adults has been highlighted as a significant public health concern. In this study, we investigated the role of psychological resilience in mediating the relationship between positive self-perceptions of aging (SPA) and the subjective well-being (SWB) of community-dwelling older adults in Taiwan during the pandemic. We collected data through face-to-face interviews conducted from October 2021 to February 2022, involving 1,095 participants aged 50 years or above residing in a southern city in Taiwan. More than half of the study participants were female, aged 65 or older, and had less than a high school education. More than two thirds were married and/or living with partners. More than a third had two or more noncommunicable diseases. We calculated scores for SWB, positive SPA, and psychological resilience and examined correlations among the outcome and predictor variables. Our findings indicated that higher positive SPA was significantly associated with better SWB among community-dwelling older adults in Taiwan and that this association was mediated by psychological resilience. Specifically, after controlling for covariates, structural equation modeling (SEM) analysis revealed a significant main effect of positive SPA on SWB (b = 0.412, β = 0187, and p < 0.001), while bootstrap mediation analysis showed a statistically significant indirect mediating effect from positive SPA on SWB via psychological resilience (0.597, 95% bootstrap CIs = [0.445, 0.749], and p < 0.001). These findings highlight the potential importance of cultivating positive self-perceptions of aging and implementing resilience-centered interventions to promote well-being among Chinese older adults in the community.

Measuring Psychological Resilience in Aging: Findings From the Health and Retirement Study and National Longitudinal Study of Adolescent to Adult Health

Article

Feb 2024

Background and Objectives This study aimed to evaluate the measurement properties of 2 emerging psychological resilience (PR) measures constructed for use in large national data sources and to test their reliability across social axes including race/ethnicity, gender, and socioeconomic status. Research Design and Methods Using 2006/2008 data, the Simplified Resilience Score and the Add Health Resilience Scale were tested using overall and multigroup measurement models in a structural equation modeling framework. Results Both PR measures perform well as reliable, 1-factor latent constructs capturing adaptive capacity at various life stages. Both measures showed measurement consistency across social axes, with specific differences in item measurement across some racial/ethnic groups. Discussion and Implications The results indicate these measures represent high quality, consistent measures of PR in nationally representative aging and health data. The availability of reliable, valid measures of PR enables consistent evaluation of resilience in health and aging processes.

The role of implicit theories of intelligence and personality in older adults' resilience: cognitive functioning and social participation as two mediators

Article

Mar 2024
AGING MENT HEALTH

Objectives: Resilience during old age reflects the capacity to adapt to changes and challenges associated with normative aging and is an important component of successful aging. Belief in the incremental theory of intelligence and personality could help older adults maintain cognitive functioning and social engagement, which may further contribute to their resilience. The current study investigated how implicit theories of intelligence and personality affected older adults' resilience and examined cognitive functioning and social participation as two mediators. Method: A total of 108 older adults aged 60-92 were recruited and completed relevant scales and cognitive tasks. Path analyses were conducted to estimate the expected mediation model. Results: The incremental theory of intelligence, but not personality, was positively related to older adults' resilience. Both cognitive functioning and social participation mediated the effect of the implicit theory of intelligence in the model without covariates. When background variables were controlled, the mediation effect of cognitive functioning remained significant, while the link between the implicit theory of intelligence and social participation was weakened. Conclusion: Older adults' implicit theory of intelligence plays a significant role in fostering resilience in late adulthood, especially through maintaining older adults' cognitive functioning.

Breaking the links between ageism and health: An integrated perspective

Article

Feb 2024
AGEING RES REV

Well-being and stress vulnerability in ovarian cancer survivors during the COVID-19 pandemic

Article

Aug 2023
J PSYCHOSOC ONCOL

Objective: This study was designed to examine (1) whether ovarian cancer (OC) survivors would have greater well-being vs. elevated distress compared to community members during a universal health stressor (COVID-19) and (2) how resources and risk factors at diagnosis predicted vulnerability to a subsequent health-related stressor. Methods: One hundred seventeen OC survivors were recruited from two academic medical centers and compared to a community-based sample on COVID-related distress and disruption. Latent class analysis identified differentially impacted groups of survivors. Results: Survivors reported lower distress than community members. Predictors of higher distress included shorter-term survivorship, greater disruption, and poorer emotional well--being (EWB) at diagnosis. Survivors were divided into high- and low-COVID-19-impact subgroups; high-impact individuals endorsed higher perceived stress and lower EWB at diagnosis. Conclusion: Survivors reported lower COVID-related distress than community participants. While depression at diagnosis did not predict later distress, EWB was a strong predictor of response to a novel health-related stressor.

Relationship Between Resilience, Community Participation, and Successful Aging Among Older Adults in South Korea: Mediating Role of Community Participation

Article

Jul 2023

A high level of resilience is positively related to successful aging. However, interventions to increase resilience in older adults are not yet available. This study aimed to examine the mediating role of community participation in the relationship between resilience and successful aging. Data from 284 individuals aged 60 years and above were analyzed in this cross-sectional study. The pathways among resilience, community participation, and successful aging were statistically significant after controlling for sociodemographic characteristics, depression, disability, and chronic disease. The analysis revealed a partial mediating effect of community participation (unstandardized estimate = .01, p < .01), explaining 16.4% of the total effect of resilience on successful aging. Promoting community participation may be beneficial for enhancing successful aging in community-dwelling older adults. Further studies to examine the causal relationship between community participation and successful aging and to develop community services are recommended to use community resources as means to support successful aging.

The Role of Mass Media in Influencing the Lifestyle of the Elderly during the COVID-19 Pandemic

Article

Full-text available

Jun 2023

The elderly represent one of the categories that was most affected by the pandemic period. The purpose of this research was to analyze the ways in which mass media and very often contradictory information flows influenced the lives and personal communications of the Romanian elderly population during the COVID-19 pandemic. In order to conduct the research, we used a mixed-methods approach. For the quantitative research, we gave a questionnaire to the elderly population of Romania, and for the qualitative research, we conducted interviews. Our quantitative sample included 881 retired persons with an age between 55 and 94 years old; the mean age was 71.48 years old with 6.6 years standard deviation. The elderly described the pandemic period using negative words: fear, loneliness, anxiety, disaster; the channel they mostly watched and trusted was the TV; they were aware of the measures they had to take to protect themselves; they missed most of the meetings with the family and the main problems they had were represented by loneliness, the inability to be with their families or the lack of access to medical services. The elderly’s mass media consumption during the pandemic was mostly represented by TV consumption; the information spread by mass media was sometimes contradictory; it influenced their behavior and may have generated feelings of anxiety among them.

A longitudinal examination of the protective effect of resilience against anxiety among older adults with high COVID-related worry

Article

Apr 2023

This longitudinal study of community dwelling older adults (N = 453) examined consequences of COVID-related worries on changes in anxiety symptoms before relative to during the pandemic. We further evaluated if pre-COVID psychological resilience (PR) buffered the impact of COVID-related worry. Pre-COVID data were collected in September 2018. COVID-related worry and COVID anxiety symptoms were collected in October 2020 (Wave 2). Controlling for pre-COVID anxiety symptoms, we examined if COVID-related worries (e.g. I'm worried that I might die from COVID-19) were associated with increased anxiety symptoms, and whether pre-COVID PR moderated the association between COVID-related worries and prospective increases in anxiety symptoms. COVID-related worries were associated with increased anxiety symptoms (β = 0.005, p < .01), whereas pre-COVID PR was associated with a decrease in anxiety symptoms (β = -0.029, p < .05). PR moderated the association; COVID-related worries were associated with greater increases in anxiety symptoms among those with low pre-COVID PR (Model η2 = 0.35). Thus, the extent to which COVID-related worries influenced psychological health was dependent on pre-COVID levels of PR. We conclude the combined vulnerabilities of low pre-COVID PR and high COVID-related worries significantly increased the psychological consequences of COVID-19 for our sample of older adults.

Physical Disability, Psychological Resilience, and COVID-Related Changes in Depressive Symptoms Among U.S. Older Adults

Article

Feb 2023

Objectives This study pursued three goals: (1) to determine how depressive symptoms among U.S. older adults changed in 2018-2020, a period transitioning to the first wave of COVID pandemic, compared to in pre-pandemic periods, (2) to determine whether physical disability predicts change in depressive symptoms in 2018-2020, and (3) to assess whether psychological resilience moderates the association between physical disability and change in depressive symptoms in 2018-2020. Methods Based on biennial longitudinal data of the Health and Retirement Study from 2010 to 2020, we used a before-after design and latent change score model to examine whether depressive symptoms change in 2018-2020 represents a continuation or departure from the overall trend of between-wave changes in 2010-2018. We also used physical disability in 2018 and psychological resilience in 2016-2018 to predict depressive symptoms change score in 2018-2020. Results In contrast to the relatively stable between-wave change trend in 2010-2018, there was an abrupt elevation in the latent change score of depressive symptoms in 2018-2020, which was primarily driven by increased affective symptoms (e.g., depressed mood, loneliness, unhappiness, and sadness). Increase in depressive symptoms in 2018-2020 was associated positively with physical disability but negatively with psychological resilience. Moderation effect of psychological resilience, however, was not significant. Discussion Our findings reveal heavier COVID-related mental health burden for older adults with physical disabilities and the potential benefits of enhancing individual psychological resilience. They also suggest that health interventions addressing the COVID impacts need to particularly focus on the affective aspects of depressive symptoms.

Association of social participation and psychological resilience with adverse cognitive outcomes among older Chinese adults: A national longitudinal study

Article

Feb 2023
J AFFECT DISORDERS

Background: Limited epidemiological evidence exists regarding the association of social participation and psychological resilience with cognitive health. This study aimed to comprehensively investigate the effects of social participation and psychological resilience on adverse cognitive outcomes among older adults in China. Methods: We used two waves (2011 and 2014) of data from the Chinese Longitudinal Survey of Health and Longevity (CLHLS), and 9765 respondents were eligible for the subsequent screening for the present prospective analysis. The Cox proportional hazards model was utilized to examine the association of social participation and psychological resilience with cognitive impairment, cognitive decline and greater cognitive decline. The restricted cubic spline plots were applied to clarify the dose-response relationships between them. Results: Compared to those with low social participation, participants with high social participation had a lower hazard ratio (HR) of 0.72 (95 % confidence interval [CI]: 0.59-0.89) for cognitive impairment, 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.78 (95 % CI: 0.67-0.90) for greater cognitive decline. Participants with high psychological resilience had an HR of 0.77 (95 % CI: 0.63-0.95) for cognitive impairment 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.85 (95 % CI: 0.73-0.98) for greater cognitive decline compared with those with low psychological resilience. Similar effects were observed for social participation score and psychological resilience score. The dose-response analysis also showed that the risk of adverse cognitive outcomes decreased gradually with increasing social participation scores and psychological resilience scores. Additionally, the multiplicative interaction between social participation and psychological resilience was not significant. Limitation: All information was collected by self-report, which may lead to biases in the process of information collection. Conclusion: In this study, social participation and psychological resilience were independently associated with a lower risk of adverse cognitive outcomes, and therefore both need to be considered as broader measures to preserve cognitive health among older Chinese adults.

Exploring the Role of Resilience and Optimism during the COVID-19 Pandemic in Older European Adults

Article

Jan 2023

Sunwoo Lee

This study examined how resilience and optimism were related to psychological well-being among older European adults during the early pandemic. The study used data sampled from the Eurofound COVID-19 survey conducted in 27 European countries during the first lockdown (April 2020). The study sample included 10,674 older adults (mean age = 69.71 ± 5.15, 68.6% women, 87.3% retired). Using structural equation modeling, the relationship between pandemic adversities, resilience, optimism, and well-being was investigated. Results indicated that resilience and optimism in part mediated the association between adversities and psychological well-being. Resilience and optimism have the potential to help older adults cope with stressful life events and other adversities. Future studies should more precisely explore the role of resilience and optimism, its formation, and the protective mechanisms that promote the psychological well-being of older adults.

Social Frailty in Late Adulthood: Social Cognitive and Psychological Well-Being Correlates

Article

Full-text available

Oct 2022
J GERONTOL B-PSYCHOL

Objectives: Social frailty poses a major threat to successful ageing, but its social cognitive and psychological wellbeing correlates remain poorly understood. This cross-sectional study provides initial insights into whether social cognitive difficulties in older age are associated with social frailty, as well as how social frailty is linked to psychological characteristics known to be important for health and wellbeing. Method: Ninety community-dwelling older adults completed measures of social frailty and social cognition (social perception, theory of mind, affective empathy, and informant-rated social behavior) as well as measures of psychological function known to be important for health and wellbeing, both positively (resilience and life satisfaction) and negatively (demoralization, social anxiety, and apathy). Measures of cognitive frailty, physical frailty and depression were also administered to test the specificity of any observed relationships with social frailty. Results: Both affective empathy and social behavior were predictive of increased social frailty, but social behavior emerged as the only unique predictor after controlling for covariates. Social frailty also predicted unique variance in all five measures of psychological wellbeing, and for three of these measures (demoralization, resilience, and life satisfaction), the effects remained significant even after adjusting for covariates. Discussion: Findings are discussed in relation to models of socioemotional aging and frailty. Potential mechanisms linking social behavior to social capital in older age are identified, as well as how loss of social resources might both directly and indirectly impact wellbeing.

The associations of pandemic-related difficulties with depressive symptoms and psychological growth among American older adults: Social support as moderators

Article

Sep 2022
J HEALTH PSYCHOL

The COVID-19 pandemic brought social, health-related, and financial risks to older adults, yet their associations with depressive symptoms and posttraumatic growth (PTG) were not systematically examined. With 3504 respondents aged 60 and over from Health and Retirement Survey, this study found pandemic-related healthcare delay and financial hardship associated with elevated depressive symptoms and decreased PTG, whereas social disruption predicted greater PTG. When confronted with multidimensional difficulties, a higher level of social support buffered depressive symptoms and enhanced PTG following healthcare delay, while those from immediate family members carried the weighing of moderation. Additionally, the moderation effect varied between support types, as exclusive instrumental support engendered more depressive symptoms and squeezed PTG by stimulating a sense of incompetence for older adults. Inversely, receiving both instrumental and emotional support helped individuals of older age against financial-related depressive symptoms. These findings shed light on older adults’ mental health promotion in a pandemic context.

Cross-sectional associations of personal efforts and beliefs and depressive symptoms among older adults in India

Article

Full-text available

Aug 2022

Whilst there is growing evidence on the increased vulnerability of older adults to depression, there is limited research on potentially mitigative factors against symptoms of depression at a population level. This research examined associations of possible protective factors (personal efforts and beliefs) and depressive symptoms among older adults in India. This cross-sectional study used data from the Longitudinal Aging Study in India with 31,464 respondents aged 60 years and above. Depressive symptoms were assessed using the 10-item Centre for Epidemiologic Studies Depression Scale. Multivariable linear regression was used while exploring the associated factors of depressive symptoms. The mean score of depressive symptoms was 2.94 (CI 2.92, 2.96). Older adults who engaged in moderate [aCoef: −0.11, CI −0.18, −0.05], vigorous [aCoef: −0.09, CI −0.16, −0.03], or both types of physical activity [aCoef: −0.10, CI −0.19, −0.02] had lower likelihood of depressive symptoms in comparison to those who were physically inactive. Older adults who participated in social activities were less likely to have depressive symptoms [aCoef: −0.44, CI −0.50, −0.39] compared to their socially inactive counterparts. Further, older adults who perceived religion as very important [aCoef: −0.29, CI −0.41, −0.17], who had high life satisfaction [aCoef: −0.78, CI −0.82, −0.73], who had good self-perceived health [aCoef: −0.29, CI −0.33, −0.25] and those who had high self-perceived social standing [aCoef: −0.39, CI −0.47, −0.31] had lower likelihood of depressive symptoms in comparison to their respective counterparts. Physical activity, social participation, voluntary work and financial contribution to family, religiosity, life satisfaction, self-perceived health and self-perceived social standing are associated with lower likelihood of depressive symptoms among community-dwelling older adults in this study. Future longitudinal studies should explore these factors that can guide interventions against depression in old age.

Impact of psychological resilience on walking capacity in older adults following hip fracture

Article

Jun 2022

Background: Community-dwelling older adults experiencing hip fracture often fail to achieve adequate walking capacity following surgery and rehabilitation. Effects of psychological factors on post-fracture walking capacity are poorly understood. Accordingly, this paper investigates effects of psychological resilience on observed walking capacity measures in older adults following hip fracture, controlling for important covariates. Methods: Data were drawn from the Community Ambulation Project, a clinical trial of 210 community-dwelling adults aged ≥60 years who experienced a minimal trauma hip fracture and were randomized to one of two 16-week home-based physical therapist-guided interventions. Psychological resilience was measured at study baseline using the 6-item Brief Resilience Scale (BRS); scores were classified into groups in order to distinguish levels of self-reported resilience. Walking capacity was assessed at study baseline and 16 weeks later using 4-Meter Gait Speed (4MGS), 50-Foot Walk Test (50FWT), and 6-Minute Walk Distance (SMWD). In multivariate analyses of covariance in which 16-week follow-up values of each walking measure were outcomes, covariates included clinical trial arm, gender, age, and baseline values of: walking measure corresponding to the outcome; body mass index; depressive symptom severity; degree of psychological optimism; cognitive status; informal caregiver need; and days from hospital admission to randomization. Results: Increases between baseline and 16 weeks later in mean gait speed in meters/sec (m/s) and walking distance in meters (m) in 4MGS, 50FWT and SMWD were 0.06 m/s (p = 0.061), 0.11 m/s (p < 0.01), and 25.5 m (p = 0.056) greater, respectively, in the most resilient BRS group compared to the least resilient BRS group. Conclusion: Higher levels of psychological resilience were associated with greater walking speed and distance. Psychological resilience represents a potentially clinically important pathway and intervention target, toward the goal of improving walking capacity among older adults known to have substantial residual disability following hip fracture.

Resilience in Children: Developmental Perspectives

Article

Full-text available

Jul 2018

Advances in developmental resilience science are highlighted with commentary on implications for pediatric systems that aspire to promote healthy development over the life course. Resilience science is surging along with growing concerns about the consequences of adverse childhood experiences on lifelong development. Resilience is defined as the capacity of a system to adapt successfully to challenges that threaten the function, survival, or future development of the system. This definition is scalable across system levels and across disciplines, applicable to resilience in a person, a family, a health care system, a community, an economy, or other systems. Robust findings on resilience in childhood underscore the importance of exposure dose; fundamental adaptive systems embedded in the lives of individuals and their interactions with other systems; developmental timing; and the crucial role of healthcare practitioners and educators as well as family caregivers in nurturing resilience on the “front lines” of lived childhood experience. Resilience science suggests that human resilience is common, dynamic, generated through myriad interactions of multiple systems from the biological to the sociocultural, and mutable given strategic targeting and timing. Implications for pediatric practice and training are discussed.

A methodological review of resilience measurement scales

Article

Full-text available

Jan 2011

Chapter 1 Resilience in Adulthood and Later Life: What Does it Mean and Where Are We Heading?

Article

Full-text available

Feb 2012
Annu Rev Gerontol Geriatr

This chapter presents an overview of resilience in later life as it relates to both intraindividual plasticity over time and to interindividual differences in developmental outcomes. It discusses the historical antecedents of the current expanding interest in this construct, challenges in its definition and measurement, the importance of understanding and designing intervention to impact resilience at multiple levels. It is argued that resilience needs to be understood in light of the interaction of personal and environmental factors, and that key aspects of resilience (protective factors, risk/adversity, outcomes) are difficult to define clearly, contributing to ambiguities in the definition of resilience in adulthood and later life. Developmental and sociocultural aspects of resilience are discussed, and these are framed in terms of not only future directions for research, but also in terms of their implications for practice and public policy.

Resilience definitions, theory, and challenges: Interdisciplinary perspectives

Article

Full-text available

Oct 2014

In this paper, inspired by the plenary panel at the 2013 meeting of the International Society for Traumatic Stress Studies, Dr. Steven Southwick (chair) and multidisciplinary panelists Drs. George Bonanno, Ann Masten, Catherine Panter-Brick, and Rachel Yehuda tackle some of the most pressing current questions in the field of resilience research including: (1) how do we define resilience, (2) what are the most important determinants of resilience, (3) how are new technologies informing the science of resilience, and (4) what are the most effective ways to enhance resilience? These multidisciplinary experts provide insight into these difficult questions, and although each of the panelists had a slightly different definition of resilience, most of the proposed definitions included a concept of healthy, adaptive, or integrated positive functioning over the passage of time in the aftermath of adversity. The panelists agreed that resilience is a complex construct and it may be defined differently in the context of individuals, families, organizations, societies, and cultures. With regard to the determinants of resilience, there was a consensus that the empirical study of this construct needs to be approached from a multiple level of analysis perspective that includes genetic, epigenetic, developmental, demographic, cultural, economic, and social variables. The empirical study of determinates of resilience will inform efforts made at fostering resilience, with the recognition that resilience may be enhanced on numerous levels (e.g., individual, family, community, culture).

Manning, L. K., Carr, D. C., & Kail, B. L. (2016). Do higher levels of resilience buffer the deleterious impact of chronic illness on disability in later life? The Gerontologist, 56 (3), 514-524.

Article

Full-text available

Jul 2014

Purpose of the study: In examining the ability of resilience, or the ability to navigate adversity in a manner that protects well-being, to buffer the impact of chronic disease onset on disability in later life, the authors tested 2 hypotheses: (a) People with greater levels of resilience will have lower levels of disability and (b) resilience will moderate the association between the onset of a new chronic condition and subsequent disability. Design and methods: This study used a sample of 10,753 Americans between the ages of 51 and 98, derived from 3 waves of the Health and Retirement Study (2006-2010). Ordinary least squares regression was used to estimate the impact of resilience on changes in disability (measured as difficulty with activities of daily living [ADLs] and instrumental activities of daily living [IADLs]) over a 2-year period using a simplified resilience score. Results: Resilience protects against increases in ADL and IADL limitations that are often associated with aging. Resilience mitigates a considerable amount of the deleterious consequences related to the onset of chronic illness and subsequent disability. Implications: Our results support our hypotheses and are consistent with claims that high levels of resilience can protect against the negative impact of disability in later life.

Documentation of Physical Functioning Measured in the Heath and Retirement Study and the Asset and Health Dynamics among the Oldest Old Study

Article

Full-text available

Jan 2004

Navigating Hardships in Old Age

Article

Full-text available

Apr 2013
QUAL HEALTH RES

Lydia Manning

Research suggests that spirituality is important to a large percentage of the older adult population and serves as a promoter of healthy aging. In this qualitative research I conducted and analyzed multiple interviews with 6 women aged 80 and older. Using multiple in-depth interviews I explored the interplay between spirituality and resilience over the life course. A grounded theory analysis of the 30 interviews was performed. The major finding is that participants used their spirituality as a tool to promote and maintain resilience in later life. I present the results as an interpretation of the participants’ perceptions of their spirituality, and indicate their reliance on spirituality to overcome hardship over the life course. In addition, I discuss the connections between spirituality and resilience. The roles these two constructs play in the lives of older adults are considered.

What is resilience? A review and concept analysis

Article

Full-text available

May 2011
Rev Clin Gerontol

Gill Windle

The complexities of defining what appears to be the relatively simple concept of resilience are widely recognized. This paper analyses the concept of resilience from a range of disciplinary perspectives and clarifies a definition in order to inform research, policy and practice. The work takes a life course approach to resilience, examining evidence derived from research across the lifespan. It incorporates the methods of systematic review, concept analysis and consultation through face-to-face meetings. The synthesis of methodological approaches enables a clear identification of the antecedents, defining attributes and consequences of resilience, validated with stakeholder partners. Through this process, resilience is defined as the process of effectively negotiating, adapting to, or managing significant sources of stress or trauma. Assets and resources within the individual, their life and environment facilitate this capacity for adaptation and 'bouncing back' in the face of adversity. Across the life course, the experience of resilience will vary. A large proportion of resilience research is routed within the discipline of developmental psychology, and has mainly been developed with children and adolescents. A major contribution to resilience research could be made through more multi-disciplinary studies that examine the dynamics of resilience across the lifespan, its role in healthy ageing and in managing loss, such as changes in cognitive functioning.

A methodological review of resilience measurement scales. Health and Quality of Life Outcomes, 9

Article

Full-text available

Feb 2011
HEALTH QUAL LIFE OUT

The evaluation of interventions and policies designed to promote resilience, and research to understand the determinants and associations, require reliable and valid measures to ensure data quality. This paper systematically reviews the psychometric rigour of resilience measurement scales developed for use in general and clinical populations. Eight electronic abstract databases and the internet were searched and reference lists of all identified papers were hand searched. The focus was to identify peer reviewed journal articles where resilience was a key focus and/or is assessed. Two authors independently extracted data and performed a quality assessment of the scale psychometric properties. Nineteen resilience measures were reviewed; four of these were refinements of the original measure. All the measures had some missing information regarding the psychometric properties. Overall, the Connor-Davidson Resilience Scale, the Resilience Scale for Adults and the Brief Resilience Scale received the best psychometric ratings. The conceptual and theoretical adequacy of a number of the scales was questionable. We found no current 'gold standard' amongst 15 measures of resilience. A number of the scales are in the early stages of development, and all require further validation work. Given increasing interest in resilience from major international funders, key policy makers and practice, researchers are urged to report relevant validation statistics when using the measures.

Resilience Significantly Contributes to Exceptional Longevity

Article

Full-text available

Jan 2010

Objective. We aim to investigate whether centenarians are significantly more resilient than younger elders and whether resilience significantly contributes to exceptional longevity. Data. We use a unique dataset from the Chinese Longitudinal Healthy Longevity Survey with the largest sample to date of centenarians, nonagenarians, octogenarians, and a compatible group of young old aged 65-79. Methods and Results. Logistic regressions based on the cross-sectional sample show that after controlling for various confounders, including physical health and cognitive status, centenarians are significantly more resilient than any other old-age group. Logistic regression analyses based on the longitudinal data show that nonagenarians aged 94-98 with better resilience have a 43.1% higher likelihood of becoming a centenarian compared to nonagenarians with lower resilience. Conclusions. Resilience significantly contributes to longevity at all ages, and it becomes even more profound at very advanced ages. These findings indicate that policies and programs to promote resilience would have long-term and positive effects on the well-being and longevity for senior citizens and their families.

The role of human capability and resilience

Article

Full-text available

Jan 2008
PSYCHOLOGIST

In this article some of the findings emerging from a research network investigating the socio-economic, biological and psychological circumstances that contribute to human capability and resilience over the life course [www.ucl.ac.uk/capabilityandresilience] are reported. The network, funded by the Economic and Social Research Council (ESRC), brought together scientists from diverse disciplines including experts from psychology, psychiatry, sociology, economics, epidemiology, geography, and social policy. The diverse backgrounds of the team reflect the complexity of the topic, which has to be tackled from different angles in order to generate a better understanding of the factors and processes that make it possible for individuals to lead healthy and rewarding lives.

Examination of a Theoretical Model of the Psychological Resilience in Older Age

Article

Full-text available

Jun 2008

This article integrates a number of theoretical perspectives and examines the concept of psychological resilience in older age. Drawing on the literature it is hypothesised that an overarching construct-resilience-accounts for the functioning of a number of psychological resources (self-esteem, personal competence and control). The factorial validity of the resources as indicators of resilience is tested using confirmatory factor analysis. The analyses focus on previously unexplored survey data drawn from a representative sample of people aged between 50 and 90 in England, Wales and Scotland (N=1847). The results find a common factor (a higher-order model) provides the best explanation of the relationships between the resources, demonstrating an important first account for developing further work on this concept. Exploring what might form the basis of resilience from a psychological perspective enables a deeper understanding of why some individuals can remain positive in difficult circumstances, particularly some of the challenges of ageing.

The Structure of Coping

Article

Full-text available

Apr 1978

Coping refers to behavior that protects people from being psychologically harmed by problematic social experience, a behavior that importantly mediates the impact that societies have on their members. The protective function of coping behavior can be exercised in 3 ways: by eliminating or modifying conditions giving rise to problems; by perceptually controlling the meaning of experience in a manner that neutralizes its problematic character; and by keeping the emotional consequences of problems within manageable bounds. The efficacy of a number of concrete coping behaviors representing these 3 functions was evaluated. Results indicate that individuals' coping interventions are most effective when dealing with problems within the close interpersonal role areas of marriage and child-rearing and least effective when dealing with the more impersonal problems found in occupation. The effective coping modes are unequally distributed in society, with men, the educated, and the affluent making greater use of the efficacious mechanisms.

Optimism, coping, and health: Assessment and implications of generalized outcome expectancies

Article

Full-text available

Feb 1985

This article describes a scale measuring dispositional optimism, defined in terms of generalized outcome expectancies. Two preliminary studies assessed the scale's psychometric properties and its relationships with several other instruments. The scale was then used in a longitudinal study of symptom reporting among a group of undergraduates. Specifically, respondents were asked to complete three questionnaires 4 weeks before the end of a semester. Included in the questionnaire battery was the measure of optimism, a measure of private self-consciousness, and a 39-item physical symptom checklist. Subjects completed the same set of questionnaires again on the last day of class. Consistent with predictions, subjects who initially reported being highly optimistic were subsequently less likely to report being bothered by symptoms (even after correcting for initial symptom-report levels) than were subjects who initially reported being less optimistic. This effect tended to be stronger among persons high in private self-consciousness than among those lower in private self-consciousness. Discussion centers on other health related applications of the optimism scale, and the relationships between our theoretical orientation and several related theories.

Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC)

Article

Full-text available

Sep 2003

Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement.

The Sense of Mastery as a Mediator and Moderator in the Association Between Economic Hardship and Health in Late Life

Article

Full-text available

Oct 2005
J AGING HEALTH

Objectives: This study examines the ways in which the sense of mastery modifies the association between economic hardship experienced at different life stages and late-life depression, anxiety, and physical symptoms. Methods: Using data from a sample of 1,167 older adults, ordinary least squares regression techniques were used to estimate the main and mastery-contingent effects of economic hardship. Results: Results underscore the dual role of the sense of mastery in the stress process. First, mastery mediates the effects of both earlier- and later-life economic hardships on elders’ current physical and mental health. Second, mastery moderates the health impact of economic hardship, although those patterns depend on the period of economic hardship and health outcome. Discussion: Integrating the stress process model and a life course perspective, the authors argue that to fully understand protective capacity of psychosocial resources, stressors encountered at different life stages should be taken into account.

Resilience in Adulthood and Later Life: What Does it Mean and Where are We Heading

Chapter

Jan 2012

Gregory C Smith

This chapter presents an overview of resilience in later life as it relates to both intraindividual plasticity over time and to interindividual differences in developmental outcomes. It discusses the historical antecedents of the current expanding interest in this construct, challenges in its defi nition and measurement, the importance of understanding and designing intervention to impact resilience at multiple levels. It is argued that resilience needs to be understood in light of the interaction of personal and environmental factors, and that key aspects of resilience(protective factors, risk/adversity, outcomes) are diffi cult to define clearly,contributing to ambiguities in the defi nition of resilience in adulthood and later life. Developmental and sociocultural aspects of resilience are discussed, andthese are framed in terms of not only future directions for research, but also interms of their implications for practice and public policy.

Education, Social Status, and Health

Book

Sep 2017

Early-Life Military Exposures and Functional Impairment Trajectories Among Older Male Veterans: The Buffering Effect of Psychological Resilience

Article

May 2018
J GERONTOL B-PSYCHOL

Objectives: Drawing on the life course framework and theoretical concept of resilience, we examine the impact of early-life service-related exposures (SREs) on later-life functional impairment trajectories among older U.S. male veterans. We conceptualize resilience as a psychological resource potentially moderating the lasting negative consequences of traumatic military exposures. Method: Using the 2013 Veterans Mail Survey linked to the Health and Retirement Study 2006-2014 Leave Behind Questionnaire and RAND Data File (v.N), we estimate latent growth curve models of functional impairment trajectories. Results: SRE to death has a persistent positive effect on functional limitations and activities of daily living limitations. Psychological resilience significantly moderates this association, such that veterans maintaining higher levels of resilience in the face of adverse exposures have considerably less functional impairment over time compared to their counterparts with low levels of resilience. Discussion: Our findings point to the importance of psychological resilience in later life, especially within the realm of traumas occurring in early life. We discuss implications for current military training programs, stressing the importance of research considering individual resources and processes that promote adaptation in the face of adverse life events.

Designing a Resilience Program for Critical Care Nurses

Article

Dec 2017

Background: Workplace stress can affect job satisfaction, increase staff turnover and hospital costs, and reduce quality of patient care. Highly resilient nurses adapt to stress and use a variety of skills to cope effectively. Objective: To gain data on a mindfulness-based cognitive therapy resilience intervention for intensive care unit nurses to see if the intervention program would be feasible and acceptable. Methods: Focus-group interviews were conducted by videoconference with critical care nurses who were members of the American Association of Critical-Care Nurses. The interview questions assessed the feasibility and acceptability of a mindfulness-based cognitive therapy program to reduce burnout syndrome in intensive care unit nurses. Results: Thirty-three nurses participated in 11 focus groups. Respondents identified potential barriers to program adherence, incentives for adherence, preferred qualifications of instructors, and intensive care unit-specific issues to be addressed. Conclusions: The mindfulness-based cognitive therapy pilot intervention was modified to incorporate thematic categories that the focus groups reported as relevant to intensive care unit nurses. Institutions that wish to design a resilience program for intensive care unit nurses to reduce burnout syndrome need an understanding of the barriers and concerns relevant to their local intensive care unit nurses.

Springer Texts in Statistics

Book

Jan 2009

Simon J Sheather

Introduction.- Simple linear regression.- Diagnostics and transformations for simple linear regression.- Weighted least squares.- Diagnostics and transformations for multiple linear regression.- Variable selection.- Logistic regression.- Serially correlated errors.- Mixed models.- Appendix: Nonparametric smoothing.

Hopelessness: Independent associations with health-related quality of life and short-term mortality after critical illness: A prospective, multicentre trial

Article

Apr 2017

Purpose: To assess the independent associations between ability to cope and hopelessness with measures of health-related quality of life (HRQoL) and their effects on mortality up to 3 years after discharge in patients who have been treated in an intensive care unit (ICU). Methods: A prospective, cross-sectional multicenter study of 980 patients. Ability to cope, hopelessness, and HRQoL were evaluated using validated scales. Questionnaires were sent to patients 6, 12, 24, and 36 months after discharge from ICU. Results: After adjustment, low scores for ability to cope and high scores for hopelessness were both related to poorer HRQoL for all subscales (except for coping with bodily pain). Effects were in the same range as coexisting disease for physical subscales, and stronger for social and mental subscales. High scores for hopelessness also predicted mortality up to 3 years after discharge from ICU (p<0.001). Conclusions: The psychological factors ability to cope and hopelessness both strongly affected HRQoL after ICU care, and this effect was stronger than the effects of coexisting disease. Hopelessness also predicted mortality after critical illness. Awareness of the psychological state of patients after a stay in ICU is important to identify which of them are at risk.

Editorial: Successful aging 2.0: Resilience and beyond

Article

Mar 2017

When Does Disadvantage Not Accumulate? Toward a Sociological Conceptualization of Resilience

Article

Jan 2009

Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. & Jaffe, M. W. Studies of illness in the aged. The Index of ADL: a standardized measure of biological and psychosocial function. JAMA 185, 914-919

Article

Sep 1963

The Index of ADL was developed to study results of treatment and prognosis in the elderly and chronically ill. Grades of the Index summarize over-all performance in bathing, dressing, going to toilet, transferring, continence, and feeding. More than 2,000 evaluations of 1,001 individuals demonstrated use of the Index as a survey instrument, as an objective guide to the course of chronic illness, as a tool for studying the aging process, and as an aid in rehabilitation teaching. Of theoretical interest is the observation that the order of recovery of Index functions in disabled patients is remarkably similar to the order of development of primary functions in children. This parallelism, and similarity to the behavior of primitive peoples, suggests that the Index is based on primary biological and psychosocial function, reflecting the adequacy of organized neurological and locomotor response.

Resilience reconsidered: Conceptual considerations, empirical findings, and policy implications.

Article

Oct 2012

Michael Rutter

Reviews the literature on the concept of resilience in children. The topic of individual resilience is one of considerable importance with respect to public policies focused on the prevention of either mental disorders or developmental impairment in young people. In planning preventive policies, it is important ot ask whether it is more useful to focus on the risks that render children vulnerable to psychopathology or on the protective factors that provide for resilience in the face of adversity. Topics covered include methodological considerations in the study of resilience, studies directly focusing on resilience, processes associated with resilience, and associated policy implications. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Hope and Hopelessness: Critical Clinical Constructs

Article

Oct 1995
J ADV NURS

This book represents 27 collective years of work in the area of hope and hopelessness, conducted by each of us in somewhat more than the past decade. In reality, this book is more about hope than hopelessness because each of us has concentrated most of our research efforts on these positive aspects of hope and its relationship to health. However, in our clinical expriences, we found that we could not deny the necessary dialectic that exists between hope and hopelessness. Hence throughout the text we attempt to give almost equal emphasis to both of these clinical constructs. The major purpose of this book is to present, integrate, and synthesize current knowledge about hope and hopelessness. For clinicians, the book will provide an understanding of these constructs and how to assess and care for persons experiencing hope and/or hopelessness. For researchers, the book provides a more centralized source on both hope and hopelessness and charts a course for future research efforts. The book is targeted to nurses, chaplains, social workers, and other health care practitioners who provide care in a variety of clinical settings. Hope in children and from cross-cultural perspectives are mentioned but do not receive a major focus because of limited work in these areas. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Resilience predicting psychiatric symptoms: A prospective study of protective factors and their role in adjustment to stressful life events

Article

May 2006
CLIN PSYCHOL PSYCHOT

Objective. The purpose of this prospective study was to explore the Resilience Scale for Adults (RSA) as a predictor for developing psychiatric symptoms when exposed to stressful life events.Methods. A healthy sample (N = 159) completed the RSA, the Hopkins Symptom Checklist-25 (HSCL-25) and the occurrence of Stressful Life Events (SLE) twice, with a three-month interval.Results. The results indicated that the RSA measures important protective factors that buffer the development of psychiatric symptoms when individuals encounter stressful life events. Two of the RSA factors, in particular, contributed to buffering the development of psychiatric symptoms.Conclusion. The findings suggest that the RSA is a significant predictor of mental health and a useful tool for further research examining individual differences in stress tolerance. Copyright © 2006 John Wiley & Sons, Ltd.

Structural Equations With Latent Variables

Chapter

Dec 1990
J AM STAT ASSOC

Kenneth A Bollen

Analysis of Ordinal Categorical Data Alan Agresti Statistical Science Now has its first coordinated manual of methods for analyzing ordered categorical data. This book discusses specialized models that, unlike standard methods underlying nominal categorical data, efficiently use the information on ordering. It begins with an introduction to basic descriptive and inferential methods for categorical data, and then gives thorough coverage of the most current developments, such as loglinear and logit models for ordinal data. Special emphasis is placed on interpretation and application of methods and contains an integrated comparison of the available strategies for analyzing ordinal data. This is a case study work with illuminating examples taken from across the wide spectrum of ordinal categorical applications. 1984 (0 471-89055-3) 287 pp. Regression Diagnostics Identifying Influential Data and Sources of Collinearity David A. Belsley, Edwin Kuh and Roy E. Welsch This book provides the practicing statistician and econometrician with new tools for assessing the quality and reliability of regression estimates. Diagnostic techniques are developed that aid in the systematic location of data points that are either unusual or inordinately influential; measure the presence and intensity of collinear relations among the regression data and help to identify the variables involved in each; and pinpoint the estimated coefficients that are potentially most adversely affected. The primary emphasis of these contributions is on diagnostics, but suggestions for remedial action are given and illustrated. 1980 (0 471-05856-4) 292 pp. Applied Regression Analysis Second Edition Norman Draper and Harry Smith Featuring a significant expansion of material reflecting recent advances, here is a complete and up-to-date introduction to the fundamentals of regression analysis, focusing on understanding the latest concepts and applications of these methods. The authors thoroughly explore the fitting and checking of both linear and nonlinear regression models, using small or large data sets and pocket or high-speed computing equipment. Features added to this Second Edition include the practical implications of linear regression; the Durbin-Watson test for serial correlation; families of transformations; inverse, ridge, latent root and robust regression; and nonlinear growth models. Includes many new exercises and worked examples.

Capturing Transitions and Trajectories: The Role of Socioeconomic Status in Later Life Disability

Article

Nov 2010
J GERONTOL B-PSYCHOL

Miles G Taylor

Disability is conceptualized as a life course process and measured using either transitions or trajectories. Previous research does not simultaneously explore both aspects of disablement, accounting for timing and trajectory. The role of education is noted in disability research, but its independent effects over time have not been fully examined. I investigate the effects of education and income on disability onset and progression over a decade. I use a latent curve modeling approach with four waves of the Duke Established Populations for Epidemiologic Studies of the Elderly data to independently test the preventive and mediating effects education and income provide for disability. Education has a preventive effect for disability onset but no significant effect on progression once income is held constant. Income has both a preventive and mediating effect on disability, although preventive effects are stronger for education. Later life disability is measured here using both onset and trajectory. Findings are consistent with health research suggesting that education and income work through shared and independent mechanisms to affect disability over time. These findings also highlight the importance of modeling timing when studying health trajectories.

Optimism

Article

Feb 2010

Optimism is an individual difference variable that reflects the extent to which people hold generalized favorable expectancies for their future. Higher levels of optimism have been related prospectively to better subjective well-being in times of adversity or difficulty (i.e., controlling for previous well-being). Consistent with such findings, optimism has been linked to higher levels of engagement coping and lower levels of avoidance, or disengagement, coping. There is evidence that optimism is associated with taking proactive steps to protect one's health, whereas pessimism is associated with health-damaging behaviors. Consistent with such findings, optimism is also related to indicators of better physical health. The energetic, task-focused approach that optimists take to goals also relates to benefits in the socioeconomic world. Some evidence suggests that optimism relates to more persistence in educational efforts and to higher later income. Optimists also appear to fare better than pessimists in relationships. Although there are instances in which optimism fails to convey an advantage, and instances in which it may convey a disadvantage, those instances are relatively rare. In sum, the behavioral patterns of optimists appear to provide models of living for others to learn from.

Aging and Cumulative Inequality: How Does Inequality Get Under the Skin?

Article

May 2009
GERONTOLOGIST

This article draws from cumulative disadvantage and life course theories to develop a new theory for the social scientific study of aging. Five axioms of cumulative inequality (CI) theory are articulated to identify how life course trajectories are influenced by early and accumulated inequalities but can be modified by available resources, perceived trajectories, and human agency. Although the concept of CI has attracted considerable attention among social scientists, it holds promise for integrating additional disciplinary approaches to the study of aging including, but not limited to, biology, epidemiology, and immunology. The applicability of CI theory to gerontology is illustrated in research on the early origins of adult health. Primary contributions of the theory to gerontology include greater attention to family lineage as a source of inequality; genes, gestation, and childhood as critical to early and enduring inequalities; the onset, duration, and magnitude of exposures to risk and opportunity; and constraints on generalizations arising from cohort-centric studies.

Optimism, Self-Mastery, and Symptoms of Depression in Women Professionals

Article

Jul 1990

The construct validity and predictive utility of dispositional optimism were examined in a sample of 192 women professionals. By using covariance structure modeling with latent variables, opotimism (Scheier & Carver, 1985) and self-mastery (Pearlin & Schooler, 1978) were found to be empirically distinct, although substantially correlated, constructs. Furthermore, although optimism and self-mastery were significant and negatively correlated with symptoms of depression, only self-mastery was independently associated with symptom levels. In addition, no evidence was found that optimism and self-mastery interact to influence depressive symptoms. These results suggest that the apparent predictive power of optimism may derive from its substantial overlap with self-mastery. Implications for the assessment and interpretation of optimism and self-mastery are discussed.

Human Aging: Usual and Successful

Article

Aug 1987

Research in aging has emphasized average age-related losses and neglected the substantial heterogeneity of older persons. The effects of the aging process itself have been exaggerated, and the modifying effects of diet, exercise, personal habits, and psychosocial factors underestimated. Within the category of normal aging, a distinction can be made between usual aging, in which extrinsic factors heighten the effects of aging alone, and successful aging, in which extrinsic factors play a neutral or positive role. Research on the risks associated with usual aging and strategies to modify them should help elucidate how a transition from usual to successful aging can be facilitated.

Self-Ratings of Health Among the Old and Old-Old

Article

Jan 1981

Kenneth F. Ferraro

The utility of self-ratings of health among the elderly is discussed. The report presents evidence from a national survey of older persons (N = 3,402) which indicates that self-ratings of health are significantly related to measures of objective health status and thus are an economical means of gaining information about the health of the elderly. Self-ratings of health are also found to be related to the age and sex of the respondents. Of particular interest is the finding that although members of the old-old category (75+) report more health-related problems than the old (65-74), they tend to be more positive in rating their own health.

Development and psychometric testing of the Resilience Scale

Article

Feb 1993
J Nurs Meas

This study describes the development and initial psychometric evaluation of the 25-item Resilience Scale (RS) in a sample of 810 community-dwelling older adults. Principal components factor analysis of the RS was conducted followed by oblimin rotation indicating that the factor structure represented two factors (Personal Competence and Acceptance of Self and Life). Positive correlations with adaptational outcomes (physical health, morale, and life satisfaction) and a negative correlation with depression supported concurrent validity of the RS. The results of this study support the internal consistency reliability and concurrent validity of the RS as an instrument to measure resilience.

Intrapersonal Resources and the Effectiveness of Self-Help Groups for Bereaved Older Adults

Article

Nov 1993

The relative impact of three intrapersonal resources (self-esteem, competencies and life satisfaction) and the duration of a self-help group intervention on levels of depression and grief were examined over time among a sample of 295 recently bereaved older adults. In general, the resources examined had a greater direct influence on outcomes than the intervention. Also, those with lower competencies reported reduced depression and grief with greater meeting attendance, whereas the opposite was at first true for those with high competencies. Depression eventually decreased, however, among those with high competencies who continued to attend self-help group meetings for more than 8 weeks. Although bereavement self-help groups can aid those who may be deficient in selected skills, it is equally important to emphasize ways the bereaved can more effectively use those strengths that they may already possess in order to facilitate adaptation.

Hopelessness and Risk of Mortality and Incidence of Myocardial Infarction and Cancer

Article

Mar 1996

We examined the relationship among low, moderate, and high levels of hopelessness, all-cause and cause-specific mortality, and incidence of myocardial infarction (MI) and cancer in a population-based sample of middle-aged men. Participants were 2428 men, ages 42 to 60, from the Kuopio Ischemic Heart Disease study, an ongoing longitudinal study of unestablished psychosocial risk factors for ischemic heart disease and other outcomes. In 6 years of follow-up, 174 deaths (87 cardiovascular and 87 noncardiovascular, including 40 cancer deaths and 29 deaths due to violence or injury), 73 incident cancer cases, and 95 incident MI had occurred. Men were rated low, moderate, or high in hopelessness if they scored in the lower, middle, or upper one-third of scores on a 2-item hopelessness scale. Age-adjusted Cox proportional hazards models identified a dose-response relationship such that moderately and highly hopeless men were at significantly increased risk of all-cause and cause-specific mortality relative to men with low hopelessness scores. Indeed, highly hopeless men were at more than three-fold increased risk of death from violence or injury compared with the reference group. These relationships were maintained after adjusting for biological, socioeconomic, or behavioral risk factors, perceived health, depression, prevalent disease, or social support. High hopelessness also predicted incident MI, and moderate hopelessness was associated with incident cancer. Our findings indicate that hopelessness is a strong predictor of adverse health outcomes, independent of depression and traditional risk factors. Additional research is needed to examine phenomena that lead to hopelessness.

Stressful Life Events Among Community-living Older Persons

Article

Dec 2002

To identify the life events that older persons experience as most stressful, to evaluate older persons' perceptions of the consequences of these stressful events for their lives, and to evaluate the relationship of demographic factors and measures of health and functional status to these perceptions. Cross-sectional study. Seven hundred fifty-four community-living persons aged 70 years or older. During a comprehensive assessment, participants identified the most stressful event that they had experienced in the past 5 years and, subsequently, rated its stressfulness and perceived consequences. Six hundred three participants (80%) identified a stressful life event. Of these, 18% identified a personal illness, 42% the death of a family member or friend, 23% the illness of a family member or friend, and 17% a nonmedical event. Although participants consistently rated their events as highly stressful, they reported widely varied consequences of these events for their lives. While 27% to 59% of participants across the 4 event types reported considerable negative consequences, 17% to 36% reported positive consequences such as starting new activities that have become important to them and changing for the better how they feel about their lives. Dependence in instrumental activities of daily living and depressive symptoms were independently associated with several negative perceived consequences. Older persons experience a wide array of stressful life events, with only a small minority reporting personal illnesses as the most stressful. Similar stressful events can have either negative or positive consequences for older persons' lives. This variation in response to stressful events among older persons may indicate different degrees of resilience, a potentially important factor underlying successful aging that deserves further investigation.

Studies of Illness in the Aged. The Index of Adl: A Standardized Measure of Biological and Psychosocial Function

Article

Oct 1963

Depressive symptoms and the buffering effect of psychological resilience on mental health following widowhood

Jan 2019
1122-1130

B M King
D C Carr
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Psychological Resilience and Health Among Older Adults: A Comparison of Personal Resources

Abstract

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