Resilience In Older Adults Research Articles

Situation model updating in young and older adults

Over the past decade or so, developments in language comprehension research in the domain of cognitive aging have converged on support for resilience in older adults with regard to situation model updating when reading texts. Several studies have shown that even though age-related declines in language comprehension appear at the level of the surface form and text base of the text, these age differences do not apply to the creation and updating of situation models. In fact, older adults seem more sensitive to certain manipulations of situation model updating. This article presents a review of theories on situation model updating as well how they match with research on situation model updating in younger and older adults. Factors that may be responsible for the resilience of language comprehension in older age will be discussed as well as avenues for future research.

Psychosocial stress associated with memory performance in older South African adults

ABSTRACTOlder adults with past or current chronic stress exposure perform poorly on memory assessments and are at higher risk for Alzheimer’s disease (AD). In low- or middle-income countries, many older adults are, or have been, exposed to stress-provoking events. Few published studies examine such populations, however, and few take multiple measures of stress. In a sample of South African older adults with mild-to-moderate AD (n = 65) and healthy controls (n = 69), we assessed relations between stress (psychosocial and physiological), memory performance, and patient status. Participants, all aged > 60, were administered the Perceived Stress Scale (a questionnaire assessing subjective psychosocial stress) and the Cambridge Cognitive Examination-Revised (CAMCOG-R; a test battery measuring performance across several cognitive domains). We measured their salivary cortisol concentrations as a proxy for physiological stress. Patients reported significantly higher levels of psychosocial stress than controls, p = .008. Logistic regression showed that psychosocial stress, but not cortisol, predicted AD patient status. CAMCOG-R Memory subscale scores were significantly associated with psychosocial stress, r = −.18, p = .040, but not with cortisol levels. These findings are the first on the topic to emerge from a low-or middle-income country. We replicated findings from previous studies conducted in high-income countries, with data supporting predictions derived from the glucocorticoid cascade/neurotoxicity hypothesis. The results suggest that clinical interventions focused on increasing resilience of older adults to effects of chronic stress may help protect against declining memory performance and reduce the risk for AD.

Pet ownership and its influence on mental health in older adults

Objectives: With aging, older adults are at risk of a decline in mental health as they experience significant life stressors that are specific to later life. It is thus important to explore the potential of suitable approaches that promote healthy aging, to address the mental health needs of older adults. Pet ownership has been found to be associated with positive mental health outcomes; however, there is limited research on the lived experience and meaning derived from pet ownership. The purpose of this study was to explore pet ownership in community-dwelling older adults and its influence on mental health.Methods: Semi-structured interviews were conducted with 14 community-dwelling older adults who were aged 65 and above and pet owners. Participants were interviewed individually on a single occasion about the meaning derived from the role of pet ownership and howthey perceived that their pet influenced their mental health.Results: Results were analysed using Colaizzi’s phenomenological framework and four themes emerged from the interviews: pets provide (i) comfort and safety; (ii) social inclusion and participation; (iii) purposeful routine and structure; and (iv) a meaningful role.Conclusion: These findings suggest that the role of pet ownership may benefit community-dwelling older adults by providing companionship, giving a sense of purpose and meaning, reducing loneliness and increasing socialisation. These benefits may also increase resilience in older adults against mental health disorders, which may positively influence their mental health outcomes.

The relationship between meaning in life and resilience in older adults: a cross-sectional study

BackgroundMeaning in life has been considered necessary for the psychological well-being of older adults. The aim of this study was to investigate the relationship between meaning in life and resilience in the elderly in Kerman, Iran.Participants and procedureIn this cross-sectional study, 300 older adults (aged more than 60 years) were included using the multistage sampling method in Kerman in 2018. The Connor-Davidson Resilience Scale (CD-RISC) was used to investigate the resilience status, and for as-sessing meaning of life, Steger’s meaning in life questionnaire was employed. Data were analyzed using Pearson correlation, chi-square, t-test, ANOVA and linear regression by IBM SPSS V21.ResultsThe mean age of participants was 67.3 ±7.9 years. Resilience status was significantly different in terms of gender (p = .021), educational status (p = .032), and self-reported health status (p = .003). There was a significant positive relationship between meaning in life and resilience (r = .38, p = .012). Independent variables (meaning in life, self-reported health status, gender) accounted for 31% of the variance in resilience (p ≤ .001).ConclusionsConsidering meaning in life and resilience in older adults helps to improve psychological health and wellness and create a unique potential ability to confront the pitfalls of old age, which result in better physical, mental, social, and spiritual health in older adults.

Two Approaches to Classifying and Quantifying Physical Resilience in Longitudinal Data.

Approaches for quantifying physical resilience in older adults have not been described. We apply two conceptual approaches to defining physical resilience to existing longitudinal data sets in which outcomes are measured after an acute physical stressor. A "recovery phenotype" approach uses statistical methods to describe how quickly and completely a patient recovers. Statistical methods using a recovery phenotype approach can consider multiple outcomes simultaneously in a composite score (eg, factor analysis and principal components analysis) or identify groups of patients with similar recovery trajectories across multiple outcomes (eg, latent class profile analysis). An "expected recovery differential" approach quantifies how patients' actual outcomes are compared to their predicted outcome based on a population-derived model and their individual clinical characteristics at the time of the stressor. Application of the approaches identified different participants as being the most or least physically resilient. In the viral respiratory cohort (n = 186) weighted kappa for agreement across resilience quartiles was 0.37 (0.27-0.47). The expected recovery differential approach identified a group with more comorbidities and lower baseline function as highly resilient. In the hip fracture cohort (n = 541), comparison of the expected recovery differentials across 10 outcome measures within individuals provided preliminary support for the hypothesis that there is a latent resilience trait at the whole-person level. We posit that recovery phenotypes may be useful in clinical applications such as prediction models because they summarize the observed outcomes across multiple measures. Expected recovery differentials offer insight into mechanisms behind physical resilience not captured by age and other comorbidities.

Validez y confiabilidad de la Escala de Resiliencia (SV-RES) para adultos mayores en Lima metropolitana

El objetivo principal del presente estudio fue analizar la validez de constructo y la fiabilidad de la Escala de Resiliencia (SV-RES) de Saavedra (2008) en adultos mayores debido a las escazas investigaciones en torno a la variable, la cual funciona como factor protector para el envejecimiento saludable. Es un muestreo no probabilístico conformado por trescientos adultos mayores pertenecientes a un centro del adulto mayor de Lima Metropolitana, entre los cuales el 43% estuvo conformado por varones y el 57% por mujeres entre sesenta y 96 años. Se aplicó el SV-RES de Saavedra (2008) y el RESIM, adaptado por Palomar y Gómez (2010) para el análisis convergente. Como resultados, el análisis factorial exploratorio del SV-RES arrojó una solución de tres factores (yo soy-estoy, yo tengo, yo puedo) que explicaron el 50,60% de la varianza total. El análisis factorial confirmatorio ofrece resultados adecuados: X2 = 108.779,922, RMSEA = 0,028, y CFI = 0,996. Las correlaciones entre la escala de resiliencia SV-RES y RESI-M fueron positivas y significativas. Mediante el uso del coeficiente alpha de Cronbach se obtuvieron valores mayores a 0,70. Estos resultados permiten concluir que el SV-RES y sus puntuaciones son una medida válida y fiable para medir la resiliencia en adultos mayores.

Cognitive Improvement in Older Adults in the Year After Hip Fracture: Implications for Brain Resilience in Advanced Aging

We examined cognitive function in nondemented, nondelirious older adults 1 year post hip fracture. Prospective observational study. Three hundred eighty-six hip fracture patients aged 60 years and older with no history of cognitive impairment, such as clinical dementia or persistent delirium, recruited from eight area hospitals 2-3 days after hip surgery (week 0), and 101 older adults with no recent acute medical events for control comparison. Cognitive function was examined with the Repeatable Battery for the Assessment of Neuropsychological Status and the Short Blessed Test (SBT) at weeks 0 (SBT only), 4, and 52 using a repeated measures mixed model analysis. Baseline predictor variables included demographics, personality, genetic factors, and depressive symptom level. Hip fracture participants had lower cognitive scores than healthy comparisons. Cognitive scores improved in the hip fracture group relative to healthy comparison participants from week 4-52. The only significant predictor of cognitive improvement after hip fracture was education: individuals with college education showed cognitive improvement by week 52, while those with high school or less did not. Nondemented, nondelirious older adults suffering hip fracture have poorer cognitive function immediately after the fracture but then exhibit cognitive improvement over the ensuing year, especially among those with high education. This demonstrates brain resilience in older adults even in the context of advanced age, medical illness, and frailty.

Alcohol consumption/dependence and resilience in older adults with high blood pressure.

ABSTRACTObjective:to evaluate alcohol consumption/dependence and resilience in older adults with high blood pressure and to analyze the factors associated with these variables. Method:a descriptive, cross-sectional, quantitative study developed with 300 older adult patients with high blood pressure from Family Health Strategy units in a municipality of Minas Gerais, Brazil. A semi-structured questionnaire called the Alcohol Use Disorder Identification Test and the Resilience Scale were used. Data were analyzed using the Pearson’s chi-square test, Fisher’s exact test, Cronbach’s alpha, odds ratio and logistic regression. Results:89.3% of the interviewees were low-risk for consuming alcoholic beverages. The variables gender, age, smoking and disease duration were significantly associated with alcohol consumption/dependence. 36.7% of the people presented a low resilience. The variables family and individual monthly income, education level, physical activity and leisure had an association with resilience. No statistically significant association was observed between alcohol consumption/dependence and resilience. Conclusion:alcohol consumption and resilience can interfere with the physical and mental health of older adults with high blood pressure.

From Lonely to Resilient through Humanoid Robots: Building a New Framework of Resilience

This paper connects different theories and methods from the social sciences and applies them to human-humanoid robot interaction (HHRI) to explain loneliness reduction and the build-up of resilience in older adults through social robots. It allows for user-related aspects such as age, social connectedness, gender role, personality, and need satisfaction as well as robot-related aspects, particularly coaching behaviors and communication styles. From these scientific considerations, solutions to design challenges are pinpointed, proposing novel interaction schemes that enhance the feeling of support and companionship. This paper also opens the way to conducting empirical research to examine HHRI-related designs, measuring user experience in HHRI, while suggesting applications in HHRI in various settings, such as coaching and eldercare.

Resilience and amygdala function in older healthy and depressed adults

BackgroundPrevious studies suggest that low emotional resilience may correspond with increased or over-active amygdala function. Complementary studies suggest that emotional resilience increases with age; older adults tend to have decreased attentional bias to negative stimuli compared to younger adults. Amygdala nuclei and related brain circuits have been linked to negative affect, and depressed patients have been demonstrated to have abnormal amygdala function. MethodsIn the current study, we correlated psychological resilience measures with amygdala function measured with resting-state arterial spin-labelled (ASL) and blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) in older adults with and without depression. Specifically, we targeted the basolateral, centromedial, and superficial nuclei groups of the amygdala, which have different functions and brain connections. ResultsHigh levels of psychological resilience correlated with lower basal levels of amygdala activity measured with ASL fMRI. High resilience also correlated with decreased connectivity between amygdala nuclei and the ventral default-mode network independent of depression status. Instead, lower depression symptoms were associated with higher connectivity between the amygdalae and dorsal frontal networks. LimitationsFuture multi-site studies with larger sample size and improved neuroimaging technologies are needed. Longitudinal studies that target resilience to naturalistic stressors will also be a powerful contribution to the field. ConclusionsOur results suggest that resilience in older adults is more closely related to function in ventral amygdala networks, while late-life depression is related to reduced connectivity between the amygdala and dorsal frontal regions.

Storytelling contributes to resilience in older adults

ABSTRACTThis study suggests that storytelling provides a protective effect in older adults, from the symptoms of narrative foreclosure, which is the notion that one has nothing left to add to their life story. Small group storytelling is proposed as a simple and helpful way to the development of resilience in older adults. This exploratory study was structured as a small group case study with mixed methods of data collection. The case provides an example of a non-pharmaceutical intervention that demonstrates implementation of a storytelling group to increase happiness and well-being in older adults. Implications suggest use in gerontology, retirement transition, and holistic and alternative therapies.

"Tough Times Have Become Good Times": Resilience in Older Adults With a Low Socioeconomic Position.

This qualitative study applied a resilience perspective to socioeconomic inequalities in the functioning of older adults. We aimed to gain insight into how some older adults managed to age successfully despite having a low socioeconomic position (SEP) throughout their lives. Semistructured interviews were conducted with 11 resilient adults over the age of 79 years participating in the Longitudinal Aging Study Amsterdam, the Netherlands. Participants were defined as resilient on the basis of having a low lifetime SEP and favorable trajectories of physical, mental, and social functioning. Grounded Theory coding techniques were applied to identify themes reflecting distinct ways in which participants dealt with what they indicated were the most significant adversities in their lives. The analysis focused on experiences linked to socioeconomic conditions. Six themes reflecting psychological, behavioral, and social factors were derived from the data: drawing support from social contacts; investing in younger generations; taking actions to manage or improve socioeconomic conditions; putting the impact of a low SEP into perspective; persevering; and resigning oneself to adversity. Findings suggest that successful aging despite a low SEP throughout one's lifetime requires considerable psychological and social resources. In addition, resignation and specific manifestations of generativity are identified as new elements of resilience. These findings may help to reduce the stereotyping of older adults with a low SEP, and nuance the heroic image of resilience as something that is primarily attributable to extraordinary individual abilities or efforts.

The relationship between resilience and cognitive function of older adults

Objective To investigate the role of resilience on cognitive function in older adults. Methods By random sampling, a total of 321 older adults participated the present study and were investigated by Connor-Davidson Resilience Scale, Mini Mental State Examination and self-designed general questionnaire. Results The score of resilience in older adults (82.75±15.13) was significantly higher than that of Chinese community people (65.40±13.90) (t=20.68, P<0.01). Older adults with poor resilience performed significantly lower on all dimensions of cognitive abilities than the other two groups (middle & higher resilience group) (all P<0.05). With both age and educational level controlled, tenacity and strength were of positive prediction for the cognitive abilities of older adults (β=0.25, 0.17, P<0.05). Conclusion There is a close relationship between resilience and cognitive function of older adults. The training of tenacity, strength and optimism will help delay the decline of cognitive function. Key words: Resilience; Cognitive function; Older adults

Dynamical Resilience Indicators in Time Series of Self-Rated Health Correspond to Frailty Levels in Older Adults.

We currently still lack valid methods to dynamically measure resilience for stressors before the appearance of adverse health outcomes that hamper well-being. Quantifying an older adult's resilience in an early stage would aid complex decision-making in health care. Translating complex dynamical systems theory to humans, we hypothesized that three dynamical indicators of resilience (variance, temporal autocorrelation, and cross-correlation) in time series of self-rated physical, mental, and social health were associated with frailty levels in older adults. We monitored self-rated physical, mental, and social health during 100 days using daily visual analogue scale questions in 22 institutionalized older adults (mean age 84.0, SD: 5.9 years). Frailty was determined by the Survey of Health, Ageing and Retirement in Europe (SHARE) frailty index. The resilience indicators (variance, temporal autocorrelation, and cross-correlation) were calculated using multilevel models. The self-rated health time series of frail elderly exhibited significantly elevated variance in the physical, mental, and social domain, as well as significantly stronger cross-correlations between all three domains, as compared to the nonfrail group (all P < 0.001). Temporal autocorrelation was not significantly associated with frailty. We found supporting evidence for two out of three hypothesized resilience indicators to be related to frailty levels in older adults. By mirroring the dynamical resilience indicators to a frailty index, we delivered a first empirical base to validate and quantify the construct of systemic resilience in older adults in a dynamic way.

Understanding Older Adults' Resilience During the Brisbane Floods: Social Capital, Life Experience, and Optimism.

The purpose of this study was to explore how social capital or the impact of life and previous disaster experience facilitated resilience in older adults who experienced the 2011 and 2013 floods in Brisbane, Australia. Data were drawn from in-depth interviews of 10 older adults from Brisbane who were evacuated in both the 2011 and 2013 floods. A combined qualitative approach drawing from the methods of constructivist grounded theory and narrative inquiry was applied and the data were analyzed by using (inductive) line-by-line and axial coding. The narratives of the older adults revealed a strong theme of resilience linked to social capital (bonding, bridging, and linking) and previous disaster experience. The results reflected the changing face of disaster management strategies and sources of social capital. Changes in disaster management polices (toward self-reliance) and more formalized sources of social capital highlight the need to build strong and healthy resilient communities that are capable of positively recovering from natural disasters. The results from this research emphasize the importance of initiatives that enhance social cohesion, trust, and social capital within local communities. (Disaster Med Public Health Preparedness. 2017;11:72-79).

Measuring Resilience in Two Generations: Psychometric Properties of Available Instruments.

This study examines measures of resilience to identify the best available measure for future research to assess efficacy of a low-cost intervention that enhances resilience of older adults and youth (i.e., intergenerational transfer of ethnic culture). Scanning the literature produced no obvious choice; 3 measures showed promise: the Wagnild-Young Resilience Scale, Windle-Markland-Woods Psychological Resilience Scale, and the Connor-Davidson Resilience Scale (CD-RISC); 200 ethnicityalike older adults and 192 youths completed all three scales. Factor analyses interpreted in consultation with a panel of community advisers showed no measure was statistically robust. The CD-RISC had acceptable reliability and a conceptually interpretable structure. Results suggest the CD-RISC, supplemented by qualitative input, provides a way forward for research on efficacy of intergenerational interventions.

Mental Health, Psychosocial Challenges and Resilience in Older Adults Living with HIV.

In addition to physical health challenges, older people living with HIV/AIDS (PLWHA) experience mental health burdens and challenges to their social well-being that diminish their overall health. These health states are synergistic and are driven by HIV and HIV treatments, the aging process itself, and psychosocial and structural conditions of their lives. However, resilience, which we understand as both a trait and a process, may serve to buffer the effects that HIV/HIV treatments, aging, and social/structural conditions may have on the overall well-being of the individual. In this chapter, we examine the extant literate on the mental health and psychosocial challenges experienced by older PLWHA as elements of the total health of the individual. We also provide a contextualization and conceptualization for understanding the significant role that resilience may play in empowering individuals to enact processes which buffer health from the stressors. In this perspective, the health of older PLWHA must be viewed through a lens of power and strength rather than one of deficit. We conclude by outlining a theoretical paradigm for the role of resilience in the health of older HIV-positive adults, which may serve as a guide to clinicians, public health practitioners, and researchers working with this population.

Association between depression and resilience in older adults: a systematic review and meta-analysis.

The objective of this study is to determine whether resilience is associated with depressive symptoms in geriatric populations. A systematic review and meta-analysis were performed (up to March 2015) following the Preferred Reporting Items for Systematic Reviews and Meta-analysis recommendations on three databases (PubMed/Medline, Scopus, and Web of Science) with no language restrictions, using a Boolean expression. For inclusion in the study, articles had to assess the older population (60 years or older), assess both depressive and resilience symptoms, and investigate the association between these two variables. Articles not employing validated resilience and depression scales or assessing populations younger than 60 years were excluded. The quality of the selected studies was assessed using the Quality Assessment Tool for Quantitative Studies. A total of 1094 articles were retrieved from the three databases, 367 of which were duplicates and therefore excluded, giving 727 articles for analysis. Of these articles, seven met the eligibility criteria. All of the included articles were observational and cross-sectional, found an inverse relationship between depression and resilience, and were conducted in three countries: the USA, China, and Belgium. A moderate inverse correlation was found on the meta-analysis (r = -0.35, 95% confidence interval: -0.41 to -0.28). Few studies were found on this subject in the older population. An association between greater resilience and less depressive symptomatology was identified, albeit based on cross-sectional studies. These results highlight the need for further studies in the area and the importance of fostering the use of interventions to promote resilience in older adults as a means of preventing and managing depressive symptoms in this population. Copyright © 2016 John Wiley & Sons, Ltd.

Life-course social and economic circumstances, gender, and resilience in older adults: The longitudinal International Mobility in Aging Study (IMIAS)

Although early socioeconomic adversity is associated with poorer function and health in adulthood, those who are able to adapt positively to such risks and threats develop a resilience that may ameliorate harm. Predictors of resilience have been examined in children, however exploring the relationship between life-course events, lived environments and current resilience among older adults across countries is novel. We specifically studied how childhood social and/or economic adversity and current socioeconomic resources were associated with resilience in 2000 community dwelling older men and women in Canada, Colombia, Brazil and Albania. The longitudinal International Mobility in Aging Study (IMIAS) collected information in 2012 and 2014 on childhood adversity, current income sufficiency social support and social engagement, and resilience (Wagnild Resilience Scale RS-14). Resilience levels were moderately high, and similar among women and men. Early social adversity predicted later resilience for some, with women but not men adapting positively. In contrast there was no bouncing back from early economic adversity. Current social engagement aligned with resilience (women only) as did social support from children (for women) and friends (for men). Partner support was of no advantage to either. Among men economic circumstances were stronger correlates of resilience while for women social circumstances were primary. The impact of site on resilience suggested that cultural norms and values have an independent effect on resilience of their populations, with strong and positive social ties more typical of Latin America than Canada appearing to offset lower absolute incomes. These findings are of importance because resilience is dynamic, can be fostered across the lifespan and is generally associated with greater health. Understanding which social assets and resources can be reinforced to build individual resilience offers a means for decreasing the harms of social and economic adversity.

Slower Decline in C-Reactive Protein after an Inflammatory Insult Is Associated with Longer Survival in Older Hospitalised Patients.

BackgroundEnhancing biological resilience may offer a novel way to prevent and ameliorate disease in older patients. We investigated whether changes in C-reactive protein (CRP), as a dynamic marker of the acute inflammatory response to diverse stressors, may provide a way to operationalize the concept of resilience in older adults. We tested this hypothesis by examining whether such changes could predict prognosis by identifying which individuals are at greater risk of 6-month mortality.MethodsAnalysis of prospective, routinely collected datasets containing data on hospitalization, clinical chemistry and rehabilitation outcomes for rehabilitation inpatients between 1999 and 2011. Maximum CRP response during acute illness and CRP recovery indices (time and slope of CRP decay to half maximum, and to <50mg/L if peak values were greater than 50mg/L) was derived from biochemistry data. 6-month survival plots were conducted on quartiles of CRP recovery indices. Cox proportional hazards models were used to test univariate and multivariate predictors of 6-month mortality. Covariates included age, sex, number of medications, serum calcium, haemoglobin level, renal function, and the presence of previous myocardial infarction, stroke, chronic heart failure, COPD and diabetes.Results3723 patients, mean age 84 years, were included. 1535 (41%) were male and 733 (20%) died during six-month follow-up. The lower an individual’s peak CRP reading, and the longer the time taken for their CRP to fall, the better their 6-month survival. The time for CRP to reach half of its maximum value was the best dynamic CRP index of survival (HR 0.93 per week, 95% CI 0.89 to 0.98; p = 0.004); this remained significant even after adjustment for maximum CRP level and covariates listed above.ConclusionCRP recovery indices are associated with survival in older people; further work is required to explain differences in physiology between patients with a fast and slow CRP recovery.