Exploring the Multidimensional Nature of Resilience in Pain and Function among Aging Adults with Chronic Low Back Pain

Abstract

Evidence supports the adaptive benefits of resilience among older adults with chronic pain. However, previous investigations have largely examined resilience factors in isolation with a predominant focus on psychological mechanisms, thereby overlooking other factors (e.g., health, social) that may attenuate pain burden. To address this gap, the current study used a multisystem approach in the examination of resilience by exploring the association of a range of protective factors with pain and physical functioning among older adults with chronic low back pain (cLBP). Community-dwelling adults (N=60) ages 60+ with cLBP completed measures of psychological (positive affect, hope, wellbeing, optimism), health (waist-hip ratio, body mass index, medical comorbidities), and social (emotional, instrumental, informational support) functioning. Principal component analysis (PCA) was then conducted to create composite domains for these measures. Participants also completed self-report measures of low back pain intensity and physical function (PROMIS), as well as a performance-based measure assessing lower-extremity function and movement-evoked pain (SPPB). Hierarchical linear regression analyses were used to assess the contribution of each multisystem resilience composite to pain intensity and physical function, after controlling for sociodemographic characteristics. PCA resulted in a three-factor solution (Component 1: positive, psychological factors; Component 2: health-related functioning; Component 3: social support) that accounted for 72.4% of the variance in the set of items. The three composite measures explained an additional 14% and 18% of the variance in SPPB function (p=.004) and PROMIS self-reported function (p=.02), respectively. Specifically, higher levels of psychological and health-related resilience were associated with greater physical function (all ps