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Navigating Adversity in Older Age: An Integrative Review of Contemporary Resilience Concepts and Measurement
Chonlakarn Songsri1, Pras Ramluggun2, Pimwalunn Aryuwat3
1Faculty of Nursing, Udon Thani Rajabhat University, Udon Thani 41000, Thailand.
Abstract:
Background/Objectives: Ageing populations face complex challenges, yet many older adults maintain well-being despite adversity. Understanding resilience offers critical direction for health promotion. This integrative review takes a conceptual and methodological approach to resilience in older adults, with clear implications for geriatric care. The review addresses: (1) how resilience is conceptualised and measured; (2) individual, social, and contextual factors linked to resilience; and (3) the effectiveness of interventions that aim to promote resilience. Methods: Following Whittemore and Knafl's framework, a systematic search of six databases (PubMed, CINAHL, MEDLINE, Scopus, Web of Science, and Cochrane CENTRAL; 2016-2025) identified 42 empirical studies across 18 countries of diverse designs. Quality was assessed using the Mixed Methods Appraisal Tool, and thematic analysis identified five convergent themes. Results: Most studies explicitly defined resilience using trait-, process-, or outcome-based frameworks and employed validated instruments, most commonly the CD-RISC. Self-efficacy, spirituality, sense of coherence, and gratitude were consistently associated with resilience. Family relationships, social networks, and community participation were important relational correlates. Health status, education, economic security, and digital literacy were key contextual factors. Six longitudinal studies linked higher resilience to reduced mortality, slower cognitive decline, and attenuated frailty progression. Seven intervention studies, including five randomised controlled trials, supported physical activity, mindfulness, positive thinking training, Tai Chi, and technology-supported exercise as promising intervention modalities, though one web-based programme yielded null findings. Conclusions: Resilience in older adults is a multifaceted and potentially modifiable construct. Growing longitudinal evidence extends its relevance beyond psychological well-being to physical health outcomes, though cross-sectional designs predominate and limit causal inference. Measurement heterogeneity across more than twenty instruments underscores the need for international consensus and culturally valid tools. Larger longitudinal studies and adequately powered trials are needed to guide definitive practice and policy for ageing populations worldwide.
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