The protective effects of psychological resilience on disability consequences of falling

This study investigated the role of psychological resilience (PR) in shaping the disablement process whereby an initial fall elevates the risk of subsequent falls and losses in physical function. Intervening in this process is an important clinical and public health goal. PR may be a key personal resource with salutary effects that is amenable to intervention.

We used Health and Retirement Study participants with longitudinal data (2006-2020). We compared non-fallers (n = 2,158 with two consecutive waves after baseline with no fall) with those who experienced a fall after baseline (n = 1,293) using bivariate tests. We used Ordinary Least Squares (OLS) regression to evaluate the moderating effect of PR on changes in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) related to falls among adults 70+. We tested whether these effects were explained by exercise and social support.

The "no fall" group had lower levels of ADL/IADL limitations at baseline and follow-up. There were no differences between the 2 groups in baseline PR, level of physical activity, and social support. Interestingly, at follow-up, those who experienced a fall had a higher physical activity score than those who did not fall. Those with higher PR experienced fewer limitations following a fall. Physical activity and social support did not entirely explain this effect.

We show that PR is an important factor that influences whether falls contribute to accelerated disability during ages when people are at the highest risk, age 70+. These findings are encouraging for researchers seeking to identify ways to reduce the costs and consequences of falls.