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Resilience of community-dwelling older persons
Susan E Hardy1, John Concato, Thomas M Gill
1Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06504, USA. susan.hardy@yale.edu
Objectives:
To assess resilience of community-dwelling older persons using a new scale based on response to a stressful life event and to identify the demographic, clinical, functional, and psychosocial factors associated with high resilience.
Design:
Cross-sectional study.
Setting:
Community.
Participants:
Five hundred forty-six nondisabled persons aged 70 and older who had experienced a stressful life event.
Measurements:
Resilience (as assessed using a simple six-item scale), demographic factors, chronic conditions, medications, cognitive status, grip strength, functional status, physical activity, self-efficacy, depressive symptoms, self-rated health, and social support.
Results:
Participants showed a wide range of resilience in response to a stressful event, with a mean score+/-standard deviation of 8.9+/-4.0 on an 18-point scale. In bivariate analyses, male sex, living with others, high grip strength, independence in instrumental activities of daily living (IADLs), having few depressive symptoms, and having good to excellent self-rated health were associated with high resilience, defined as a score in the best tertile (>10). Independence in IADLs (relative risk (RR)=1.36, 95% confidence interval (CI)=1.05-1.69), having few depressive symptoms (RR=1.59, 95% CI=1.13-2.11), and good to excellent self-rated health (RR=1.38, 95% CI=1.01-1.79) remained independently associated with high resilience in multivariate analysis. Depressive symptoms and self-rated health remained associated with high resilience after controlling for the perceived stressfulness of the event.
Conclusion:
Functional and psychosocial factors are associated with high resilience. Further research is needed to determine the relationship between resilience and future well-being.