The Association of Increasing Resilience with Positive Health Outcomes and Quality of Life Among Older Adults

Abstract

Introduction Background: Resilience, generally defined as the ability to adapt to changes and cope with life's challenges, has been recognized as a concept central to successful aging. As currently interpreted, resilience is operational primarily when an individual is exposed to stressors or trauma. Higher resilience has been associated with positive mental health while a direct impact on physical health outcomes has been less consistent. Objective To investigate three levels of resilience (low, medium, and high), identify characteristics associated with medium and high resilience and measure the impact of increasing resilience on selected health outcomes: quality-of-life (QOL), healthcare utilization, expenditures and preventive services compliance. Methods Methods: The study sample was identified from adults age ≥65, covered by an AARP® Medicare Supplement Insurance Plan from UnitedHealthcare, who had completed a health survey during May-June 2019 (N=3,573). Resilience was measured using the Brief Resilience Scale and categorized to three levels: low, medium, and high. Other positive resources, including purpose-in-life, locus of control, social participation, and optimism, were dichotomized as high/low and counted with equal weighting as a continuous variable ranging from 0-4. Quality of life was measured from the health survey; healthcare utilization, expenditures and preventive services from administrative databases. Results Results: Among weighted survey respondents, the prevalence of low, medium, and high resilience levels were 27%, 29%, and 43%, respectively. Higher resilience was evident among males and those younger than 80 years. The strongest predictors of medium and high resilience included increasing number of other positive resources, lower stress, and no depression. Adding an additional positive resource increased the likelihood of having medium resilience by 50% and almost doubled the likelihood of having high resilience. Physical health conditions were minimally associated with resilience levels. Individuals with medium and high resilience had significantly higher QOL, lower healthcare utilization and less healthcare expenditures. Preventive services compliance was not associated with resilience. Conclusions Conclusions: Interventions promoting the maintenance and/or increase of resilience should include a focus on other positive resources and stress/depression management. Resilience strategies integrated into healthy aging programming could be associated with improvements in QOL and healthcare utilization and expenditure outcomes. This research was funded by he authors declare no conflicts of interest with respect to the research, authorship, and/or publication of this article. The authors received no financial support for the research, authorship, and/or publication of this abstract. Background: Resilience, generally defined as the ability to adapt to changes and cope with life's challenges, has been recognized as a concept central to successful aging. As currently interpreted, resilience is operational primarily when an individual is exposed to stressors or trauma. Higher resilience has been associated with positive mental health while a direct impact on physical health outcomes has been less consistent. To investigate three levels of resilience (low, medium, and high), identify characteristics associated with medium and high resilience and measure the impact of increasing resilience on selected health outcomes: quality-of-life (QOL), healthcare utilization, expenditures and preventive services compliance. Methods: The study sample was identified from adults age ≥65, covered by an AARP® Medicare Supplement Insurance Plan from UnitedHealthcare, who had completed a health survey during May-June 2019 (N=3,573). Resilience was measured using the Brief Resilience Scale and categorized to three levels: low, medium, and high. Other positive resources, including purpose-in-life, locus of control, social participation, and optimism, were dichotomized as high/low and counted with equal weighting as a continuous variable ranging from 0-4. Quality of life was measured from the health survey; healthcare utilization, expenditures and preventive services from administrative databases. Results: Among weighted survey respondents, the prevalence of low, medium, and high resilience levels were 27%, 29%, and 43%, respectively. Higher resilience was evident among males and those younger than 80 years. The strongest predictors of medium and high resilience included increasing number of other positive resources, lower stress, and no depression. Adding an additional positive resource increased the likelihood of having medium resilience by 50% and almost doubled the likelihood of having high resilience. Physical health conditions were minimally associated with resilience levels. Individuals with medium and high resilience had significantly higher QOL, lower healthcare utilization and less healthcare expenditures. Preventive services compliance was not associated with resilience. Conclusions: Interventions promoting the maintenance and/or increase of resilience should include a focus on other positive resources and stress/depression management. Resilience strategies integrated into healthy aging programming could be associated with improvements in QOL and healthcare utilization and expenditure outcomes.