The impact of resilience among older adults

Healthy aging in frail older adults: Active aging project of a national survey

Background

Frailty is a growing concern among the aging population. Due to their vulnerability and reduced physiological reserves, frail older adults face an increased risk of functional decline and loss of independence. In frail older adults, the concept of healthy aging emphasizes maintaining independence, functionality, and a high quality of life despite frailty and other age-related challenges.

Objective

Grounded in the multidimensional model of healthy aging and aging-related resilience theory, we aimed to propose and test a hypothesized model. The model included exogenous variables (cognitive and physical function, perceived health) and mediators (resilience, social support, and daily activity) as influencing factors of healthy aging among frail older adults.

Methods

The cross-sectional study was conducted in South Korea using a national survey of 505 frail older adults living in the community. The sample was representative across age groups, sex, and regional distributions. A structural equation modeling was employed to test a hypothesized model, examining both direct and indirect effects of influencing factors on healthy aging. Data were collected between October and December 2023 and analyzed using IBM SPSS 26.0 and AMOS 26.0.

Results

A total of 505 frail older adults with an average age of 74 participated in the study. The hypothesized model demonstrated a good fit with the data. The exogenous variables and mediators accounted for 43 % of the variance in healthy aging. Resilience, cognitive function, and perceived health had significant direct and indirect effects on healthy aging. Daily activity also had a significant direct effect on healthy aging. Social support, while not directly affecting healthy aging, exerted a significant indirect effect through daily activity. Similarly, physical function influenced healthy aging indirectly via daily activity. The model was tested after controlling for age, sex (ref=male), economic status, and years of education. Among these confounding variables, economic status was a significant influencing factor in healthy aging (β = 0.14, p = 0.016).

Conclusion

Cognitive and physical function, alongside resilience and social support as mediators, significantly associated with healthy aging in frail older adults through daily activity. Health promotion strategies could focus on resilience and social support to empower individuals and strengthen social connectedness, thereby supporting independence in daily life and healthy aging. Further, we need to explore diverse social and cultural activities associated with healthy aging in this population to expand the definition of active aging.

Longitudinal Trajectories of Psychological Resilience and Cognitive Impairment Among Older Adults: Evidence From a National Cohort Study

OBJECTIVES

The relationship between resilience trajectories and cognitive health is not well understood. This study aimed to identify clusters of psychological resilience trajectories in a national sample of older adults and to examine the association with cognitive impairment over time.

METHODS

This study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018, and 2,788 respondents were included in this prospective analysis. Using a group-based trajectory modeling approach, we identified resilience trajectory groups over a 6-year period. Cox proportional hazards models were used to assess the relationship between the resilience trajectory groups and cognitive impairment.

RESULTS

Three distinct trajectories of psychological resilience, including decreasing resilience group (n = 131, 4.7%), persistent middle resilience group (n = 1,808, 64.8%), and persistent high resilience group (n = 849, 30.5%). During the 6-year follow-up, compared to those with persistent high resilience, participants with persistent middle resilience (hazard ratios [HR] = 1.40, 95% confidence intervals [95% CI] = 1.11-1.75) and decreasing resilience (HR = 2.31, 95% CI = 1.65-3.23) remained consistently associated with a higher risk of cognitive impairment. The associations between resilience trajectories and cognitive impairment varied by lifestyle and health conditions.

DISCUSSION

Psychological resilience is a relatively stable trait among older adults in China, with most individuals maintaining a persistently high or middle level of resilience throughout the follow-up period; however, declining psychological resilience was significantly associated with the risk of cognitive impairment. Therefore, developing targeted interventions to strengthen psychological resilience in older adults is crucial for promoting cognitive health and successful aging.

Navigating life's challenges: A randomized 6-week online intervention study to enhance resilience in working-age adults

Psychological resilience describes a trainable capacity that allows us to cope with adversity and adapt to stressful life events. This study aimed to investigate the efficacy of a 6-week online resilience intervention in students and working-age individuals. We randomly assigned 174 participants aged between 18 and 54 years (74.1% female) to either an intervention (n = 86, Mage = 24.83, SDage = 5.93) or a wait-list control group (n = 88, Mage = 23.30, SDage = 4.49). The intervention group received a 6-week flexible, asynchronous online resilience training consisting of 12 short videos. We assessed resilience, perceived stress, and worries in both groups. Mixed-ANCOVA results indicated that participants assigned to the intervention group significantly increased their resilience scores (Mdiff = 3.65, p < .001) and reduced negative emotions such as perceived stress (Mdiff = 4.18, p < .001) and worries (Mdiff = 5.09, p < .001). We observed no significant changes in the wait-list control group. The intervention group's ability to enhance resilience through watching two short videos per week supports the idea that resilience is trainable. Online resilience interventions represent a promising opportunity to acquire novel coping strategies in order to strengthen resilience and manage life's upcoming challenges.

Life Review Interventions in Improving Mental Health and Well-Being of Older Adults in Institutional Care

This study examines the impact of life review interventions on depression, resilience, and overall well-being among older adults residing in institutional settings in Ernakulam, Kerala. Using a pre-post experimental design, 201 participants from 18 institutions underwent a structured 12-session life review intervention facilitated by trained social work students. Results showed significant improvements in depression, resilience, and overall well-being. The findings underscore the importance of addressing unresolved issues and nurturing ego integrity in later life. The study advocates for integrating life review interventions into standard care practices for older adults, highlighting interdisciplinary collaboration among geriatric social workers, psychologists, and healthcare providers.

The Psychological Outcomes of Direct and Indirect Exposure to Trauma: The Lebanese Experience

Studies have consistently highlighted a high prevalence of mental health difficulties following exposure to trauma. These symptoms can become even more prevalent if one experiences several traumatic events. This study is the first to explore the interaction effect of age and gender on the prevalence of psychological outcomes, including anxiety, depression, stress, and PTSD, investigating whether the impact of age on psychological health is different across genders. Our sample included 546 Lebanese adults who were exposed to both the 2020 Beirut Port explosion and the 2023 earthquakes. Participants completed the PCL-5, the DASS-21, and a series of demographic questions. Results showed that, in the context of direct exposure, the findings for male and female participants indicate that older age is associated with lower mental health symptomatology. Analyzing indirect exposure, age was not significantly correlated with psychological outcomes for males; however, significant negative relationships were observed for all outcomes for females. Findings are discussed from a cultural perspective, emphasizing recommendations for interventions targeting people affected by traumatic events, namely the importance of focusing on the young generation, namely females, who scored the highest on psychological difficulties following indirect exposure to trauma.

Lessons From the Past, Hope for the Future: A Qualitative Study on the Lives of Leprosy-Affected Residents of a Leprosy Settlement in Malaysia

The Sungai Buloh Leprosarium in Malaysia, established in 1930, provided relief for many individuals with leprosy, yet their personal narratives remain largely untold. This study explored the lived experiences of older individuals affected by leprosy at the Leprosarium, focusing on their concerns, needs, and challenges. By examining the historical context and key themes from interviews with leprosy-affected participants, the study aimed to enhance their well-being and provide insights applicable to leprosy-affected individuals in the community, other leprosaria, and older individuals in institutional care settings. The participants comprised eight women and ten men, aged 41-84 years, with a mean age of 73.7 years. These participants, selected via purposive and snowball sampling, were interviewed for 40-45 minutes over two sessions to allow rest breaks. The interviews were transcribed, validated, and analyzed using NVivo 14 software through an inductive-deductive thematic approach. Results showed hope is a transformative coping strategy, emerging as the overarching theme, guiding participants through the challenges of leprosy. Other themes included navigating the bio-psychosocial challenges of leprosy, life within the leprosarium, practical coping strategies in daily life, parental separation from infants at birth and its emotional toll, and expressing gratitude for the opportunities and care provided by the leprosarium. These themes demonstrated how hope shaped participants' resilience and resourcefulness, enabling them to positively reframe their experiences. This study emphasized the role of hope and the importance of support systems in fostering resilience and improving the quality of life of individuals with leprosy and older adults in institutional care settings.

Factors Influencing Physical Performance and Quality of Life in Post-COVID-19 Patients

Background: This study aims to identify the factors related to demographic variables and physical performance associated with quality of life (QoL) in post-COVID-19 pa-tients who have recovered from mild infection and were not hospitalized. Methods: Seventy-four post-COVID-19 individuals who recovered from mild COVID-19 infec-tion were assessed for the baseline demographic variables (age, sex, height, weight, body mass index; BMI) and clinical information (comorbidities, duration of COVID-19 infection, and exercise habits). Vital signs (heart rate, blood pressure, and oxygen sat-uration; SpO2) were measured. Physical performance was evaluated for upper- and lower-limb muscle strength, ability of balance, and cardiorespiratory performance. All participants were assessed for QoL. Results: Hand grip strength was negatively asso-ciated with gender and age while positively associated with the duration of COVID-19. Quadricep strength also showed a negative association with gender and duration of COVID-19. Age was positively associated with multiple quality of life dimensions, while emotional role limitations were negatively associated with the duration of COVID-19 and waist circumference. Mental health was negatively linked to BMI. Conclusions: This study highlights the complex impact of COVID-19 on physical per-formance and QoL, revealing that older adults often report better QoL despite reduced muscle strength, particularly in women. The findings emphasize the need for targeted rehabilitation programs addressing both physical and emotional health for vulnerable groups.

Quality of life in older patients with cancer and related unmet needs: a scoping review

BACKGROUND

Older patients form the largest group of cancer patients yet remain underrepresented in clinical research. This scoping review aims to synthesize findings on quality of life (QoL) in older adults with cancer, comparing them to younger counterparts and older individuals without cancer, and identifying associated factors.

METHODS

PubMed and PsychINFO databases were searched for articles published until January 2024. Studies were included with exclusively older adults with cancer (≥ 65 years), age-mixed samples (mean/median ≥ 70 years), or that report results separately for older and younger adults with cancer. Out of 6, 397 identified studies, 87 met the inclusion criteria.

RESULTS

Most studies were cross-sectional, conducted in 14 countries with a mean age of 74.2 years. Physical QoL (PQoL) demonstrates an age-related decline, primarily influenced by comorbidity burden, physical activity, and lifestyle. In contrast, mental QoL (MQoL) remained stable or increased with advancing age, reflecting resilience and effective coping by older patients. While cognitive and role functioning tended to show stable or declining values with age, findings regarding social functioning were mixed. Socioeconomic factors, e.g. education, income, or marital status, mainly impacted MQoL, as well as other QoL domains. Symptom management and social support represent unmet needs that contribute to QoL impairments. Older adults with cancer underreport symptoms they perceive as normal for their age, experience ageism in healthcare, and reduced social participation.

INTERPRETATION

Comprehensive, multidisciplinary cancer care is essential for older adults with cancer, focusing on the prevention of functional health decline, geriatric assessment, socioeconomic health disparities, and enhancing symptom management.

Psychological Resilience and Cognitive Functioning in Black and White Men and Women

BACKGROUND AND OBJECTIVES

Psychological resilience is associated with better physical and mental health, but little is known about its role in cognitive health from an intersectional perspective. This study aimed to assess the relationship between psychological resilience and cognitive function across subgroups of older non-Hispanic Black and White men and women while taking stress exposure into account.

RESEARCH DESIGN AND METHODS

A total of 453 participants (Black men = 87; Black women = 147; White men = 98; White women = 121) from the Michigan Cognitive Aging Project completed the Brief Resilience Scale and a neuropsychological battery. Analyses of variance were used to assess differences in psychological resilience across the intersection of gender and race. Linear regressions assessed relationships between psychological resilience and global cognition, controlling for sociodemographics and discrimination. Interaction terms and stratified regressions characterized these relationships across intersectional groups.

RESULTS

The level of psychological resilience did not differ across intersectional groups despite differences in stress exposure. Higher resilience was associated with better global cognition in the whole sample (β = 0.12, p = .002), but this association was found only among Black men (β = 0.40, p < .001).

DISCUSSION AND IMPLICATIONS

Levels of resilience did not differ between Black and White older adults, despite disproportionate stress exposure among Black older adults. Links between psychological resilience and cognition may depend on stressors and resources that are differentially patterned across intersectional groups. Psychological resilience may be particularly important for cognitive health among Black men, who are frequently underrepresented in cognitive aging research.

The Psychological Resilience of Older Adults Is Key to Their Independence in Instrumental Activities of Daily Living and Social Participation

Background/Objectives: The link between stress and performance in instrumental activities of daily living (IADLs) and participation in older adults is gaining importance. The existing evidence is based on single measures of salivary cortisol levels; therefore, there is a need for more comprehensive studies that incorporate long-term measurements of cortisol concentrations as indicators of chronic stress. In consequence, the objective is to determine whether perceived stress, hair cortisol concentration, and psychological resilience are related to IADLs and participation in older individuals. Methods: A sample of 63 individuals with a mean age of 76.5 years underwent an assessment of stress variables (Perceived Stress Scale, hair cortisol concentration, and Resilience Scale), IADLs (UPSA Scale), and participation (PART-O Scale). Using the stress variables as factors, multiple linear regressions were conducted to predict UPSA and PART-O scores and their respective subscales. The correlation between UPSA and PART-O was also examined. Results: After controlling for age, gender, and cognitive status, resilience emerged as the sole independent predictor of overall scores on both scales, as well as on two subscales: UPSA-Communication and PART-O-Others, for which hair cortisol was also a predictor. The effect size of the association between UPSA and PART-O scores was small. Conclusions: psychological resilience is not only a protective variable against stress but also appears to be associated with instrumental functioning and social participation in older adults. This finding suggests that resilience plays a role in facilitating IADLs and participation among the elderly population.

Cognitive processing, resilience, and family functioning as contributors to posttraumatic growth in family caregivers of patients with Alzheimer's disease

OBJECTIVES

The present study examined the existence of posttraumatic growth (PTG) and its association with cognitive processing, resilience, and family functioning in family caregivers of patients with Alzheimer's disease (AD).

METHOD

Family caregivers (N = 114) were surveyed using measures of cognitive processing, resilience, family functioning, and PTG. Data were analyzed using descriptive statistics, Pearson correlations, and multiple regression analyses.

RESULTS

The average PTG score in the sample was 48.6 (SD = 18.7; range 14-105). Race, education level, severity of the patient's AD, cognitive processing, resilience, and family functioning explained 25.8% of the variance in PTG (F [9, 95] = 5.025, p < 0.001). Race was significantly correlated with PTG; specifically, non-White caregivers reported higher PTG than White caregivers (p < 0.05). When controlling for race and education level, mild AD, intrusive rumination, and family satisfaction were significant predictors of PTG (p < 0.05). However, deliberate rumination, resilience, and family communication were not significant predictors PTG (p > 0.05).

CONCLUSION

These findings provide insight into factors that may influence the development of PTG in family caregivers of patients with AD. Results may inform intervention strategies to mitigate the negative consequences of caregiving and promote PTG in this caregiver population.

Identify the direct and indirect impacts of the community built environment on the health of older adults

Background

The global ageing population is increasing. As their physical functions deteriorate, older adults face not only physical health challenges but also mental health issues. Enhancing the health status of older adults is imperative to improve their quality of life. However, research on the health status of older adults living in the community is limited, and the association between the built environment and daily activities remains largely unexplored.

Objective

This study aimed to utilize structural equation modeling to (1) explore the interrelationships between the community built environment, daily activities of older adults, and their health, and (2) examine the interrelationships among their correlates.

Methods

For data collection, this study administered structured questionnaires to 494 community-dwelling older adults across ten representative urban communities in Fuzhou, China. The questionnaire comprised four validated sections: demographic characteristics, perceived community built environment features, daily activity and health outcomes. Data analysis employed structural equation modeling (SEM) using AMOS 27.0, with SPSS 27.0 for preliminary analyses, to examine both direct effects of built environment on health outcomes and indirect effects mediated through daily activities.

Results

Structural equation modeling revealed three pathways: Path 1 (community built environment →health of older adults), Path 2 (community built environment → daily exercise for older adults), and Path 3 (daily exercise for older adults →health of older adults). All three pathways were supported, indicating interaction among the factors.

Conclusion

The health status of older adults is influenced by their living environment and daily activities. An improved community built environment can enhance health status among older adults. Furthermore, daily activities serve as partial mediators between community built environments and health outcomes. Our methodology and findings offer valuable insights for optimizing community built environments to promote the health of older adults.

The shock of Awe experience to our soul is more directly on cognitive well-being than affective well-being

Previous research has demonstrated that the experience of awe can alleviate negative emotions, such as stress related to life and career, consequently enhancing overall happiness. Drawing from the broaden-and-build theory of positive emotions, the mechanism through which awe mitigates stress and enhances happiness lies in its capacity to restructure an individual's original cognitive framework and foster a more open-minded approach to problem-solving. This, in turn, facilitates the cultivation of both physical and mental resources, including the enhancement of psychological resilience, thereby empowering individuals to better rebound from adversity and pressure. The study seeks to validate this perspective. In this study, 342 Chinese college students (awe group, pleasant group and neutral group) were investigated to test the effects of awe on cognitive well-being and affective well-being using a recall priming task paradigm. Results indicated that: (1) compared with pleasant and neutral groups, awe experience not only had a direct effect on cognitive well-being (life satisfaction), but it also had a significant indirect effect on cognitive well-being through a mediating variable - resilience. However, (2) awe experience had no direct effect on affective well-being (emotional balance), although the mediating effect of resilience was significant. This suggested that awe, as a transcendent positive experience, might have different effects or mechanism on individuals' cognition and emotion evaluation.

The role of society and family in adolescents' disaster resilience: A qualitative study

BACKGROUND

Resilience is a person's ability to adapt to life problems and crises and is influenced by many factors. Due to the increase in the number and severity of disasters, disaster preparedness policies should be developed at different levels and among multiple groups. More attention should be given to vulnerable groups. The aim of the present study is exploring the role of society and family in adolescents' disaster resilience.

METHODS

The present study was conducted using a qualitative method with content analysis approach. The participants were 28 high school teachers in Bam city, who were selected based on the purpose, to be the least 10 years of age at the time of the Bam earthquake, willingness and ability to provide experiences, active participation in this study and filling the written consent form. Sampling was continued until data saturation. The data were collected via in-depth and semi-structured interviews and analyzed with the steps suggested by Granheim and lundman method.

RESULTS

The data analysis revealed 452 open codes, 192 conceptual codes after integration, 14 subcategories, and 4 categories of factors affecting resilience against disasters. The categories included resilience strengthening and restraining factors in the family and society.

CONCLUSION

The results of the present study revealed the importance of family and society function in adolescent resilience, which can be used to help crisis management practitioners and decision makers plan community preparedness and improving Support Systems especially in schools, before disasters or Situational and predictable crisis.

The impact of resilience and coping strategies on depressive symptoms among Korean American older adults during COVID-19

OBJECTIVES

This study examined how resilience and coping strategies were associated with depressive symptoms among Korean American older adults during COVID-19. The prevalent depressive symptoms and low use of mental health services in this population have raised significant concerns among healthcare professionals. Therefore, this study aims to understand the relationships between resilience and coping types on depressive symptoms and provide valuable insights into addressing these issues within this ethnic group.

METHOD

A cross-sectional survey was conducted with 132 Korean American older adults. Hierarchical linear regression analyses were performed to assess the effect of sociodemographic factors (age, gender, marital status, years of living in the U.S., self-rated health, financial security), resilience, and coping strategies (problem-focused coping, emotion-focused coping, avoidant coping) on depressive symptoms. Next, the interactions between resilience and three coping strategies for depressive symptoms were tested.

RESULTS

The findings show that depressive symptoms were associated with financial security and avoidant coping. Also, resilience interacted with avoidant coping and emotion-focused coping. Among the participants with low resilience, depressive symptoms increased rapidly when avoidant and emotion-focused coping strategies increased, respectively.

CONCLUSION

This study emphasizes the importance of culturally tailored interventions to promote resilience and decrease avoidant and emotion-focused coping among Korean American older adults.

Childhood adversities and home atmosphere as determinants of resilience in old age: findings from the Helsinki birth cohort study

Early life stress has far-reaching effects on various aspects of well-being in later life, but whether it impacts resilience, i.e., the ability to tolerate hardship, in old age remains unclear. We investigated whether childhood adversities and childhood home atmosphere are associated with resilience in old age directly or indirectly through poorer physical and psychological functioning in late middle age. The data comprised 1176 persons born in 1934-1944 and were collected over a 17-year follow-up in 2001-2018. Childhood adversities (greater score indicates more adversities) and home atmosphere (greater score indicates better atmosphere) were assessed retrospectively. Resilience in old age was measured with the Hardy-Gill Resilience Scale, depressive symptoms in late middle age with the Beck Depression Inventory, and hand grip strength in late middle age with a dynamometer. Data were analyzed with path modeling with depressive symptoms and grip strength set as mediators. We found that a greater number of childhood adversities and a poorer home atmosphere were associated with poorer resilience in old age (β =  - .13; p < .001 and β = .11, p < .001, respectively). These associations were fully mediated by depressive symptoms, but not hand grip strength, in late middle age. The findings indicate that adverse childhood exposures may decrease psychological functioning in middle age, and subsequently, lessen resilience in old age. Future studies should assess whether this pathway can be intervened.

Development and validation of the multi-dimensional health resilience scale for community-dwelling adults

Introduction

Resilience measures generally are not health specific, nor do they account for the multiple dimensions required for individuals to overcome health challenges. To bridge this gap, we developed and validated a multi-dimensional Health Resilience Scale (HRS) for community-dwelling adults in Singapore.

Methods

We followed standard procedures to develop health resilience construct, identify dimensions, and generate potential items. Expert review and cognitive interviews were conducted to assess content validity and item clarity. The refined 35-item HRS was administered to 650 eligible community-dwelling adults in a cross-sectional survey, along with validation measures, to assess construct validity (including factorial, concurrent, convergent, and divergent validity) and internal consistency reliability.

Results

Exploratory factor analysis revealed five factors with 22 items, each factor containing 3 to 5 items. Confirmatory factor analysis confirmed the five-factor structure with good model fit. The five factors identified in the analysis were conceptualised as the following dimensions of the HRS: "Health mindset," "Perceived health access," "Social resourcefulness," "Relational support," and "Adaptive adjustment." The dimensions of "Health mindset," "Perceived health access," and "Adaptive adjustment" exhibited moderate and positive correlations with psychological resilience (concurrent validity) as well as hope and self-efficacy (convergent validity). All dimensions had weak or no correlation with maladaptive coping, depression, and anxiety measures (divergent validity). Individuals with better health status scored higher, while those with recent health adversity scored lower on the HRS, confirming divergent validity. Internal consistency reliability was confirmed with Cronbach's alpha exceeding 0.80 for the total scale and ranging from 0.73 to 0.88 for individual dimensions.

Conclusion

The 22-item multi-dimensional HRS demonstrated good reliability and validity, making it an effective tool for assessing health resilience and guiding initiatives aimed to enhance well-being among community members.

A cross-sectional network analysis of successful aging in a resilience-based framework

Aging inevitably gives rise to many challenges and transitions that can greatly impact our (mental) well-being and quality of life if these are not controlled adequately. Hence, the key to successful aging may not be the absence of these stressors, but the ability to demonstrate resilience against them. The current study set out to explore how resilience and successful aging may intersect by investigating how various resilience capacity-promoting (protective) and resilience capacity-reducing (risk) factors relate to mental well-being and quality of life. Through a large-scale (N = 2000, age 55+, 30 factors) network analysis, we established the interplay between risk/protective factors from various domains, including demographics, (mental) health, (environmental) stress, lifestyle, coping/personality, and ageism. We revealed some unique pathways through which each of these factors contribute to individuals' mental well-being and/or quality of life, and interpreted these findings in terms of a resilience-based framework of successful aging. Our findings emphasize the complexity of factors that can impact quality of life and mental well-being in later life and can steer researchers and practitioners in devising efficacious, multi-pronged interventions that target risk and protective factors simultaneously, thereby maximizing their potential in boosting beneficial outcomes among older individuals.

Physical Activity Amid a Pandemic: How Socioeconomic and Demographic Factors Shaped Behaviors During COVID-19

The COVID-19 pandemic led to significant shifts in societal norms and individual behaviors, including changes in physical activity levels. This study examines the relationship between socioeconomic and sociodemographic factors and changes in physical activity levels during the pandemic compared to pre-pandemic levels among adult Arkansans. Survey data were collected from 1,205 adult Arkansans in July and August 2020, capturing socioeconomic and sociodemographic characteristics and information on physical activity changes since the onset of the pandemic. Descriptive statistics and multinomial logistic regression analyses were conducted to assess the relative risk of reporting increased or decreased physical activity compared to unchanged levels. Age (RRR more physical activity =0.98, RRR less physical activity =0.98), marital status (RRR less physical activity =0.66), COVID-19-related income loss (RRR less physical activity =0.61), and receipt of a stimulus check (RRR less physical activity =0.64) were significantly associated with changes in physical activity levels during the pandemic. Older individuals, married individuals, those without COVID-19-related income loss, and recipients of stimulus checks were less likely to report decreased physical activity levels. No significant association was found between race/ethnicity and physical activity changes. This study highlights the influence of socioeconomic and sociodemographic factors on physical activity behaviors during the COVID-19 pandemic. These findings underscore the importance of considering socioeconomic and sociodemographic factors in public health interventions to promote physical activity and mitigate health disparities beyond the pandemic.

What Factors are Associated with Posttraumatic Growth in Older Adults? A Systematic Review

OBJECTIVES

Posttraumatic growth (PTG) is of increased theoretical and clinical interest. However, less is known about PTG in older adults specifically. This systematic review aimed to identify domains where PTG is studied for older adults; investigate factors associated with PTG in older adults; consider how these might differ between historical and later life traumas.

METHODS

Online databases were searched for quantitative studies examining PTG outcomes in adults aged ≥ 60 years.

RESULTS

15 studies were subject to a narrative synthesis.

CONCLUSIONS

Older adults can experience substantial levels of PTG, from traumas during later life or across the lifespan, and historical wartime traumas. Traumas can be diverse, some studies found equivalent levels of PTG from different traumas across the lifespan. Social processes may be a key variable for older adults. Additional psychosocial factors are found; however, diverse findings reflect no overall model, and this may be consistent with variations found in other PTG literature.

CLINICAL IMPLICATIONS

Clinical considerations are discussed. As diverse studies, findings may not be widely generalizable and directions for further research are highlighted. PROSPERO: CRD42020169318.

Effects of Situational Loneliness on Mental Health and Sleep Health Outcomes among White Older Adults during the COVID-19 Pandemic

OBJECTIVES

This study examined the cross-sectional and 2-year prospective associations between situational loneliness and health outcomes in older adults during the COVID-19 pandemic.

METHODS

Data were collected using an online survey that evaluated behaviors (e.g., socialization) and health outcomes at two points (May-June 2020 and October-November 2022) during the pandemic. Logistic regression was used to analyze the cross-sectional associations between situational loneliness and health outcomes (i.e., depressive symptoms, anxiety symptoms, and sleep health) while linear regression was used to examine the prospective associations.

RESULTS

In a sample of 428 older adults (age 65 +), situational loneliness was associated with short-term, but not long-term, increases in depressive symptoms, anxiety symptoms, and problems with sleep.

CONCLUSION

Findings suggest that the older adult population demonstrates resilience in the face of short-term increases in loneliness. Thus, promoting resilience may be a promising strategy for mitigating the negative consequences of situational loneliness.

Features and Needs of Autistic Older Adults: A Delphi Study of Clinical Experiences

OBJECTIVES

In geriatric psychiatry Autism Spectrum Disorders (ASD) are increasingly recognized. This study explores what clinicians know about diagnostic and/or therapeutic aspects of autistic older adults and how aging plays a role in the course of ASD.

METHODS

A Delphi study outlines the point of view of 11 clinical experts in the Netherlands and Belgium (Flanders).

RESULTS

Regarding diagnostics, age-specific aspects need to be considered. Age-related characteristics (cognitive differences, life events, co-occurring conditions) influence detecting autistic features in older adults. Regarding treatment, counseling methods need to be adapted. Psychoeducation, family therapy, couples therapy, behavioral counseling and psychopharmaca can be helpful in meeting the needs of autistic older adults. There was no consensus on the effects of aging on autistic older adults.

CONCLUSIONS

Diagnosis and treatment of ASD need adaptation for autistic older adults. Further research is needed on the validation of measurement tools, recorded treatment, therapy, psychoeducation, and the effects of aging among people on the autism spectrum.

CLINICAL IMPLICATIONS

Available knowledge helps clinicians to detect ASD in older adults and adapt to the specific features and needs of autistic older adults. The effects of aging on the course of ASD are unclear yet.

COVID-19 infection, resilience, and depressive symptoms: the protective role of family functioning for aging Chinese adults in Hong Kong

OBJECTIVES

Older adults are at an elevated risk of experiencing long COVID, with post-COVID-19 depressive symptoms being prevalent. However, the protective factors against this remain understudied. This study examined (a) the role of resilience in the association between COVID-19 infection and depressive symptoms in aging adults; (b) the moderating role of family functioning in the relationships between COVID-19 and resilience and between resilience and depressive symptoms; and (c) potential gender differences in the moderation.

METHOD

Data were drawn from the first wave of the Panel Study of Active Ageing and Society, a representative survey of Hong Kong adults aged 50 or above. Mediation and moderated mediation analyses were conducted.

RESULTS

Approximately 35% of the participants had tested positive for COVID-19. Resilience significantly mediated the association between COVID-19 infection and post-COVID-19 depressive symptoms (p < 0.001). Family functioning was a significant moderator: the COVID-19-resilience association was stronger, and the resilience-depressive symptoms association was weaker among participants with higher family functioning. The moderating role of family functioning was more salient in women than in men.

CONCLUSION

Resilience can protect aging adults from post-COVID-19 depressive symptoms. Interventions for enhancing family functioning may promote the formation of resilience, especially among older women.

Social support and depressive symptoms among migrant elderly following children: the chain mediating role of resilience and loneliness

BACKGROUND

Migrant elderly following children (MEFC) is an emerging special elderly mobile migrant population in China. MEFC face multiple dilemmas of distress, which makes their depressive symptoms more prominent. To explore ways to alleviate depressive symptoms, this study aimed to investigate the chain mediating effects of resilience and loneliness on the relationship between social support and depressive symptoms among MEFC.

METHODS

A cross-sectional study was conducted using purposive sampling from Changsha, Hunan Province, China, and 298 MEFC were included. The 15-item Geriatric Depression Scale, Social Support Rating Scale, University of California Los Angeles Loneliness Scale, and Connor-Davidson Resilience Scale were used to measure depressive symptoms, social support, loneliness, and resilience, respectively. Pearson's correlation analysis was conducted to clarify the association between the variables. The PROCESS macro model 6 was applied to analyze the multiple mediating effects.

RESULTS

The prevalence of depressive symptoms among MEFC was 29.86%. Social support (r = -0.354, P < 0.001), resilience (r = -0.373, P < 0.001), and loneliness (r = 0.483, P < 0.001) were significantly associated with depressive symptoms. Social support not only had a direct negative effect (Effect= -0.086, 95% CI: -0.149 to -0.023) on depressive symptoms, but also had an indirect effect on depressive symptoms through resilience (Effect= -0.045, 95% CI: -0.076 to -0.015), loneliness (Effect= -0.053, 95% CI: -0.091 to -0.020), and the chain mediating effects of resilience and loneliness (Effect= -0.019, 95% CI: -0.037 to -0.007), respectively.

CONCLUSIONS

The prevalence of depressive symptoms was relatively high. Resilience and loneliness partially mediated the association between social support and depressive symptoms. In the future, interventions could focus on increasing social support to enhance resilience and reduce loneliness, thereby reducing depressive symptoms in MEFC.

The Relationship Between Self-Compassion and Resilience in the General Population: Protocol for a Systematic Review and Meta-Analysis

BACKGROUND

Resilience can protect individuals from the negative impact of adversity, facilitating a swift recovery. The exploration of protective factors contributing to resilience has been a central focus of research. Self-compassion, a positive psychological construct that involves treating oneself with kindness, holds the potential to bolster resilience. Although several studies have indicated an association between self-compassion and resilience, there is a lack of systematic reviews and meta-analyses examining this relationship and the potential moderators and mechanisms.

OBJECTIVE

This study aimed to systematically review the literature on the relationship between self-compassion and resilience in the general population, perform a meta-analysis to quantify the effect size of their association, and explore potential moderators (eg, age, gender, culture, and health status) and mediators.

METHODS

We will search the Web of Science, PsycINFO, MEDLINE, Scopus, CINAHL, and CNKI databases for peer-reviewed studies (including observational and experimental studies) that examined the relationship between self-compassion and resilience, with no language restrictions. There are no restrictions regarding participants' age, gender, culture, or health status. Qualitative studies, conference abstracts, review articles, case reports, and editorials will be excluded. Two reviewers (XL and JH) will independently screen the literature, extract data, and assess the quality of the eligible studies. If possible, the pooled effect size between self-compassion and resilience will be meta-analyzed using a random-effect model. Meta-regression and subgroup analysis will be conducted to examine the moderating roles of age, gender, culture, health status, and other potential moderators. The characteristics and main findings of eligible studies will be summarized in tables and narrative descriptions. Results from the meta-analysis, meta-regression, and subgroup analysis will be presented quantitatively.

RESULTS

We registered our protocol with PROSPERO, conducted the search, and initiated the screening in April 2024. We expect to start data analysis in October 2024 and finalize the review by March 2025.

CONCLUSIONS

The systematic review and meta-analysis will provide evidence on the protective role of self-compassion in resilience under adversity. Our investigation into potential moderators will highlight the contexts and groups where the benefits of self-compassion can be maximized. The findings are expected to provide valuable insights for health care professionals and stakeholders, informing the development of interventions aimed at enhancing resilience by fostering self-compassion.

TRIAL REGISTRATION

PROSPERO CRD42024534390; https://tinyurl.com/3j3rmcja.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/60154.

Depression in older adults and its associations with sleep and synaptic density

BACKGROUND

Depression among older adults is a global concern, contributing to disability and overall illness burden. Understanding its trajectory, associated risk factors, and implications for mortality is essential for effective intervention. Moreover, the relationship between depression, sleep disturbances, and synaptic density in the ageing brain remains complex and poorly understood.

METHODS

Using data from the University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age cohort, comprising 6375 participants, we conducted comprehensive assessments of depression trajectories using generalized linear mixed models and mortality risks using Cox mixed-effects models. Generalized structural equation modelling was performed to explore longitudinal associations between sleep duration and depression. Lastly, associations between post-mortem synaptic density and depression were investigated.

RESULTS

Our findings revealed that depression rates declined until age 80 before increasing again. Depression was associated with a 10 % increased risk of mortality in older adults. Reduced sleep was correlated with depression, and depression measured early in the study predicted future reduced sleep. Post-mortem analysis showed a global reduction in synaptic density associated with depression, particularly pronounced in the frontal lobe.

LIMITATIONS

Limitations include recall bias, limiting generalizability due to dominantly including White British participants and difficulty in establishing causation between synaptic density and depression.

CONCLUSION

Our study underscores the significance of addressing depression in older adults, not only for mental health but also for mortality risk and neurobiological health. Early detection and intervention strategies are crucial for improving outcomes in elderly populations, potentially mitigating adverse effects on sleep, synaptic density, cognitive health, and longevity.

A qualitative exploration of the lives lived by Irish centenarians

Centenarians are of particular importance to aging research as they represent the living architype of exceptional longevity and as such studying their attributes is expected to contribute to one's understanding of survivorship. While much centenarian research to date recognizes the biological and genetic determinants in achieving advanced age, there is a lack of understanding regarding the influence of social factors and their role in aging. As centenarian populations continue to grow at an unprecedented rate, the heterogeneity among centenarian cohorts together with current aging trends highlights the intrinsic need to better understand centenarian aging from a biopsychosocial perspective. A key challenge for research concerning centenarians is understanding their personal experiences of reaching this momentous age as such information could help to identify the sociodemographic and psychosocial factors that enable people to live such extraordinarily long lives. To address this, this study focused on the lived experience of Irish centenarians and explored their understanding of their aging in a rapidly modernized sociocultural Ireland. Documenting the psychosocial profiles of centenarians will assist key stakeholders including researchers, practitioners, and policymakers in the development of policies and strategies to support the growing population of older adults in Ireland. Furthermore, this research will also map Irish centenarians who have not previously been explored onto the international nexus of centenarian research.

Shifting focus from ideality to reality: a qualitative study on how quality of life is defined by premanifest and manifest Huntington's disease gene expansion carriers

BACKGROUND

Understanding quality of life (QoL) is important in diseases for which there is no cure to date, such as Huntington's disease (HD). A deeper level of understanding is, however, compromised by the lack of studies examining QoL from the perspectives of HD gene expansion carriers (HDGECs). Only a few qualitative studies on QoL in HD have been performed, yet none investigated how QoL is defined by HDGECs themselves.

OBJECTIVE

This qualitative study explores how premanifest and manifest HDGECs define their QoL.

METHODS

Online semi-structured interviews were conducted with 6 premanifest and 6 manifest HDGECs in the Netherlands. Qualitative content analysis was used to explore participants' QoL definitions via inductive coding and the subsequent formulation of (sub)categories and (sub)themes.

RESULTS

Premanifest and manifest HDGECs had a different focus when defining QoL. Two subthemes were identified for premanifest HDGECs: Thoughts about a meaningful life regardless of HD and Concerns about the future progression and impact of HD. For manifest HDGECs, two other subthemes were identified: Coming to terms with HD and Shifting perspectives due to the impact of HD. One overall theme was generated, reflecting the difference and adaptive shift in focus between premanifest and manifest HDGECs: Shifting focus from ideality to reality.

CONCLUSIONS

In providing optimal care, HDGECs should be considered as part of a complex, continuously changing environment, thereby taking into account their individual QoL experiences and tailoring care accordingly. HDGECs might benefit from forming helpful beliefs about future adaptability and resilience and developing adaptive coping strategies.

Resilience and hopelessness mediate the relationship between benevolent childhood experiences and life satisfaction: evidence from a cross-cultural study

BACKGROUND

A growing body of literature focuses on the role of benevolent childhood experiences (BCEs) in predicting adulthood well-being, in addition to adverse childhood experiences (ACEs). However, cross-cultural differences are generally ignored in this endeavor. Hence, this study aimed to explore the role of BCEs in predicting life satisfaction, resilience, and hopelessness. We also examined the potential of resilience and the role of hopelessness in mediating the relationship between BCE and life satisfaction.

METHODS

A total of 850 university students from Turkey (n = 371), Portugal (n = 248), and India (n = 231), aged 17 to 58 years (M = 22.12, SD = 4.41), participated in the study. Participants completed an online protocol consisting of measures to assess BCEs, life satisfaction, resilience, and hopelessness.

RESULTS

BCEs, hopelessness, and life satisfaction have significantly differed among the samples based on the country of residence. BCEs were positively correlated to resilience and life satisfaction and negatively to hopelessness. In the sequential mediation model, after controlling for country and sex, resilience and hopelessness sequentially mediated the relationship between BCEs and life satisfaction. BCEs were associated with life satisfaction, resilience, and hopelessness across countries and sexes. The model explains 42.8% of the variability.

CONCLUSION

Despite differences between countries, BCEs are important predictors of adult well-being in all three countries and should be monitored along with ACE. Further, resilience seems to have an important role in lowering the negative consequences of lower BCEs and feelings of hopelessness, pointing to the need to strengthen psychological resilience among adults.

Adverse childhood experiences and ICD-11 complex posttraumatic stress disorder in Poland: a population-based study

Background: Research on the prevalence of ICD-11-based complex posttraumatic stress disorder (CPTSD) in nationally representative samples is lacking, with no such studies conducted considering national Polish samples until now.Objectives: The primary aim of this study was to explore profiles of study participants in terms of either PTSD or CPTSD symptoms regarding to ICD-11 diagnosis with the aid of latent profile analysis. We also investigated the relationship between the types and cumulative number of adverse childhood experiences (ACEs) with the probability of CPTSD rate in a national sample of Poles.Methods: A representative sample of Polish adults (n = 3,557) participated in this study. ACEs were assessed using the Adverse Childhood Experiences Questionnaire, while the core features of PTSD and CPTSD were measured using the International Trauma Questionnaire.Results: The findings showed a 11% prevalence rate of probable CPTSD in the studied sample of Poles. Sexual abuse, emotional neglect, physical neglect and having the experience of a mentally ill household member were the most significant predictors of potential diagnosis. Furthermore, significant differences concerning lifestyle data were observed in the group of participants with CPTSD.Conclusions: The current rate of probable CPTSD in Poland is substantially higher than the respective data reported for other countries. We also noted that the ICD-11 diagnosis of CPTSD may not apply to all cultural environments. Finally, it was observed that the ACEs - CPTSD association may depend both on the ACEs types as well as on their overall cumulative character.

Death Anxiety and Resilience in Older Adults: The Moderating Role of Attachment Patterns

The unique human awareness of the fact that life is finite, and that death is unavoidable has been shown to elicit negative psychological consequences across the life cycle. However, research has demonstrated that the ability to seek, maintain, and gain comfort from close relationships mitigates the adverse psychological effects of death awareness/anxiety. Moreover, relatively little is known about how death anxiety and social relationships in old age are associated with resilience, an important personal protective factor for dealing with general and age-related difficulties. Accordingly, the current work examined the links between death anxiety and resilience in older adults and explored the potential moderating role of attachment patterns for this link. Data were collected from 369 older Israeli adults (Mage = 73.15, SD = 6.31, range = 60-94), who completed scales examining death anxiety, attachment patterns, and resilience, as well as sociodemographic scales. The results demonstrated that death anxiety, attachment anxiety, and attachment avoidance were associated with reduced resilience. Moreover, the death anxiety-resilience link was not significant for individuals reporting high or low levels of both attachment anxiety and avoidance. The findings are discussed through the prism of Terror Management Theory, and practical implications are suggested.

Comparison of executive functions in people with high and low resilience

BACKGROUND

The purpose of the present study was to compare executive functions in people with high and low resilience.

METHODS

Based on the results of a structured clinical interview and Connor- Davidson resilience Scale (CD-RISC), a total of 140 adults were assigned to high resilience (n = 70) and low resilience (n = 70) groups. Working memory, inhibition and cognitive flexibility were assessed by N-Back, Go/No-Go and Wisconsin Card Sorting task, respectively.

RESULT

The results showed that individuals with high resilience compared to individuals with low resilience scored significantly higher on inhibition and cognitive flexibility, but there were no significant differences on working memory.

CONCLUSION

The current findings suggest a role of high-level cognitive processes in resilience, which in turn may contribute to mental health. Also, the results of this research may be important in the design of therapeutic interventions based on executive functions.

A comparative retrospective longitudinal study of arthritis risk and cognitive decline in older adults

Arthritis often results in unmet healthcare needs for older adults with cognitive decline, who may struggle to communicate pain or recall symptoms. However, the risk factors for arthritis in this group remain underexplored. We addressed this gap by identifying and comparing arthritis risk factors among older adults with varying cognitive statuses. Data from 334 participants with cognitive decline and 808 participants with normal cognition were analysed using the Korean Longitudinal Study of Aging, tracking arthritis diagnoses over 12 years with Kaplan-Meier curves and Cox proportional hazards regression. Results showed 47.6% of older adults with cognitive decline developed arthritis, compared with 30.1% with normal cognition. Key risk factors for the cognitive decline group included depressive symptoms (hazard ratio [HR]: 1.87), living alone (HR: 1.66), infrequent social interactions (HR: 1.42), and greater dependency in daily activities (HR: 1.41). In the normal cognition group, additional chronic illnesses (HR: 1.41) and higher body mass index (HR: 1.09) were significant risk factors. Understanding these distinct risk factors is crucial for preventing and managing arthritis among at risk groups. Moreover, these findings can assist in developing comprehensive public health strategies integrating mental health and social support to improve health outcomes for older adults with cognitive decline.

Number of Chronic Conditions and Death Anxiety Among Older Adults in Rural China: A Longitudinal Study in Anhui Province

Objectives: Death anxiety is feelings of worry and fear regarding death. This study explored the effect of number of chronic conditions on death anxiety in older adults and the moderating effect of age. Methods: This study used the fifth, sixth, seventh, and eighth waves of longitudinal data (2012-2021) collected in Anhui, China (5014 person-year observations). A mixed linear model was used to examine the effect of number of chronic conditions on death anxiety and the moderating effect of age. Results: The number of chronic conditions showed an inverted U-shaped relationship with death anxiety, with death anxiety being lower in older adults with older age. As age increased, the U-shaped curve became flatter, and the extremes shifted to the right. Discussion: Particular attention should be given to younger older adults with chronic conditions to help them recover earlier from the negative impact by providing information and counseling about their chronic conditions.

Contributors to mental health resilience in middle-aged and older adults: an analysis of the Canadian Longitudinal Study on Aging

OBJECTIVES

Identifying the correlates of mental health resilience (MHR)-defined as the discrepancy between one's reported current mental health and one's predicted mental health based on their physical performance-may lead to strategies to alleviate the burden of poor mental health in aging adults. Socioeconomic factors, such as income and education, may promote MHR via modifiable factors, such as physical activity and social networks.

DESIGN

A cross-sectional study was conducted. Multivariable generalized additive models characterized the associations between socioeconomic and modifiable factors with MHR.

SETTING

Data were taken from the population-based Canadian Longitudinal Study on Aging (CLSA), which collected data at various data collection sites across Canada.

PARTICIPANTS

Approximately 31,000 women and men between the ages of 45 and 85 years from the comprehensive cohort of the CLSA.

MEASUREMENTS

Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. Physical performance was measured objectively using a composite of grip strength, sit-to-stand, and balance performance. Socioeconomic and modifiable factors were measured by self-report questionnaires.

RESULTS

Household income, and to a lesser extent, education were associated with greater MHR. Individuals reporting more physical activity and larger social networks had greater MHR. Physical activity accounted for 6% (95% CI: 4 to 11%) and social network accounted for 16% (95% CI: 11 to 23%) of the association between household income and MHR.

CONCLUSIONS

The burden of poor mental health in aging adults may be alleviated through targeted interventions involving physical activity and social connectedness for individuals with lower socioeconomic resources.

From the ground up: stakeholders' representations of the Irish longitudinal study on ageing (TILDA)

Healthy ageing, which is the target of life' s later developmental stage, can be achieved through building a wise perspective towards life and existence. However, it may not be achievable for older people when the societal sources are limited. The TILDA project aimed to evaluate the associated factors with healthy ageing and to transfer that knowledge into practice. Hence, determining the perspectives of older people support and advocacy organisations on the enablers and facilitators of the healthy ageing strategies of TILDA is essential to gain a better understanding of the project and plan future strategies. This study aimed to investigate how the TILDA project has influenced or impacted upon these organisations from education, policy, or practice perspectives. The participants (n = 15) included in the study's sample were reached through representative organisations acting to support older people in the Republic of Ireland. Semi-structured interviews were conducted online via Zoom. A systematic thematic data analysis procedure was followed, and three themes emerged from the qualitative data, revealing the perceptions of participants about the TILDA project: (1) Limitations of TILDA, (2) Contributions of TILDA, and (3) Future recommendations for TILDA. In conclusion, among the disadvantages of TILDA, the most significant is not being representative and visible enough; it is evident that it is pivotal to develop a more inclusive culture of TILDA with close cooperation and effective marketing strategies. It is also apparent that TILDA has several advantages that include providing insights into ageing and rich data to plan future support for older people.

Elder abuse victimization, mental health, and protective factors

OBJECTIVES

This study investigated the association between elder abuse and depressive symptoms, as well as protective factors against adverse mental health outcomes from elder abuse.

METHODS

Participants were drawn from the 5928 graduates of the WLS, Wave 3 study (age range 70-73) who completed both in-person and telephone interviews. From this large group, 975 (16.4%) participants reported having experienced elder abuse and were included in the sample. Path analysis using Mplus was employed.

RESULTS

Elder abuse victimization was significantly associated with depressive symptoms, and those who had suffered multiple types of elder abuse experienced more severe mental health outcomes. However, both light physical activity conducted alone and having a friend as a confidant were negatively associated with depressive symptoms among older adults who had experienced elder abuse.

CONCLUSION

Given the significant association between elder abuse and negative mental health outcomes among older survivors, screening and prevention programs are recommended. Older adults who have experienced elder abuse may benefit from programs designed to increase physical activity and help older adults build and maintain close relationships with friends and confidants.

Lifestyle, Cognitive, and Psychological Factors Associated With a Resilience Phenotype in Aging: A Multidimensional Approach on a Population-Based Sample of Oldest-Old (80+)

OBJECTIVES

To investigate the determinants of resilience phenotype in aging, operationalized as the maintenance of cognitive, physical, and psychological health in very old individuals (80+), we investigated the structure and interrelated impact of the main resilience-enhancing factors, which are usually studied in separate research fields.

METHODS

Participants were older adults without dementia recruited for the fifth wave of the InveCe.Ab population-based cohort study (aged 83-87 years). Multidimensional evaluation comprised blood sampling, social and lifestyle survey, and geriatric and neuropsychological assessment. We classified resilient individuals as displaying normal cognition, functional independence, and mental health. First, we performed exploratory factor analysis (EFA) to examine the underlying structure of the relevant cognitive, lifestyle, physical, and psychological resilience-enhancing factors. The factors obtained were included as predictors of the resilience phenotype in the logistic regression model, controlling for sociodemographic and cumulative exposure to physical and psychosocial stressors, including COVID-19 infection.

RESULTS

Among the 404 enrolled participants, 153 (38%) exhibited the resilience phenotype. EFA resulted in the identification of six factors (59% of variance): cognitive reserve, affective reserve, insecure attachment, current lifestyle, physical reserve, and avoidant attachment. Among these factors, cognitive reserve, affective reserve, and current lifestyle significantly and independently predicted resilience status, controlling for cumulative exposure to age-related stressors and COVID-19 infection.

DISCUSSION

Our findings showed that, even in very old age, both early and late life modifiable factors affect individuals' ability to adapt to the aging process, thus confirming the importance of a life-course approach to improve health outcomes in the aged population.

CLINICAL TRIALS REGISTRATION NUMBER

NCT01345110.

"When I go back to painting, I am 'Alice in Wonderland": older women coping with age-related crises through visual artmaking

BACKGROUND

The creative process of visual artmaking provides an opportunity for older women to express themselves and explore their emotions, thoughts, and experiences. This study examined the roles of visual artmaking in older women's lives in general and in relation to the ongoing challenges of aging.

METHODS

The sample was composed of 21 Israeli women aged 60-90, who indicated that they produced visual artworks on an ongoing basis. The participants' artworks were collected, and semi-structured in-depth interviews were conducted.

RESULTS

A thematic analysis of the interviews revealed 4 themes: visual artmaking to address the challenges of older women's lives, artwork as a framework for doing, visual artmaking to support the wellbeing of older women, artwork as channel of communication and stronger ties with family members.

CONCLUSIONS

The findings contribute to a better understanding of the roles of visual art in older women's lives, especially in times of crisis.

Resilience and successful aging: A systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis investigates the relationship between successful aging (SA) and resilience in older adults, focusing on individuals aged 60 and above, to address a significant gap in understanding how resilience contributes to SA.

METHODS

Following the Cochrane review guidelines, we conducted searches in databases such as Web of Science, PsycNet, and PubMed up to December 2021 and used PRISMA as a tool for reporting the results. Our inclusion criteria were studies on psychological resilience and SA in older adults aged 60 and above. Exclusion criteria included studies on physical resilience, medical outcomes of SA, other indicators not used in screened studies (e.g., prevalence, means), populations with suicidal ideation or chronic/palliative illnesses, studies considering resilience as an indicator of SA, and qualitative studies on the association between resilience and SA.

RESULTS

A total of 21 studies were included and assessed for risk of bias using funnel plot and trim-and-fill methods. The meta-analysis revealed a medium effect size indicating a positive relationship between resilience and SA. However, high heterogeneity warrants a cautious interpretation of these results. No significant differences were found between older adults in the general population and those in retirement communities, nor were geographical variations (Asia, Europe, America) found to moderate this relationship.

DISCUSSION

The findings highlight the intrinsic link between older adults' attitudes towards aging, their subjective evaluations, and their level of psychological resilience. Resilience acts as a protective factor against psychological and physical adversities, underscoring the importance of resilience-enhancing strategies in interventions aimed at promoting SA. The conclusions drawn from this analysis should be approached with caution due to the heterogeneity of the included studies.

Resilience and Self-Compassion: Shields Against Age-Related Declines in Oral Health and Shame

Objective This study aimed to investigate the complex relationships between demographic factors, oral health indicators, self-compassion, and psychological well-being among elderly individuals by using a path model analysis. Methods The findings of this cross-sectional study are derived from data collected from a sample of 204 patients, including 120 females and 84 males, aged between 60 and 92 years, with an average age of 74.2 years (SD = 7.1). Participants took part in assessments including the Geriatric Oral Health Assessment Index (GOHAI) to measure oral health (physical function, psychosocial function, pain/discomfort), self-compassion scale, and measures of shame and "other as shamer" experiences. Demographic information including age and gender was also collected. Path analysis was employed to examine the direct and indirect effects of demographic variables, oral health indicators, and self-compassion on psychological well-being. Results Older age was consistently associated with poorer oral health outcomes across all GOHAI oral health subscales. However, resilience and self-compassion appear to exert a correspondingly large positive influence, neutralizing the negative effects of increasing age on physical and psychosocial aspects of oral health-related quality of life. Additionally, resilience was positively associated with better physical and psychosocial function related to oral health while oral health was confirmed to be related to internal and external (social) shame. However, resilience and self-compassion outperformed oral health as far as their effect on internal and external (social) shame is concerned. Gender had minimal effects on most outcome variables. Conclusions The findings underscore the importance of addressing both physical and psychological aspects of health in elderly care and oral health interventions. By promoting psychological resilience and self-compassion, healthcare providers can potentially enhance oral health-related quality of life and overall well-being among elderly populations. Our results also highlight that promoting social and leisure activities may be a means of improving mental well-being, enhancing oral health outcomes, and reducing shame-related distress among elderly individuals.

The Connection between Sleep Patterns and Mental Health: Insights from Rural Chinese Students

BACKGROUND

The association between sleep patterns and young students' mental health, which is crucial for their development, remains understudied in rural China. Therefore, the relationship between sleep patterns and mental health among primary and junior high school students in rural China was examined.

METHOD

A total of 1592 primary and junior high school students from rural areas of Gansu Province were surveyed, and the Depression Anxiety and Stress Scale (DASS) was utilized to assess mental health, alongside self-reported data on their daily sleep patterns.

RESULTS

Significant sleep inadequacies were identified: 28% of students received less than 8 h of sleep on weekdays, and 19% went to bed later than recommended. On weekends, 38% of students had delayed bedtimes, though only 7.2% received less than 8 h of sleep. Notably, a "U-shaped" relationship was uncovered between sleep duration and mental health for students on weekends, with optimal mental health correlated with receiving 10-11 h of sleep, while both shorter and longer sleep durations on weekends worsened outcomes. This pattern is absent on weekdays. Additionally, adequate sleep and an earlier bedtime was linked to a 6-8% decrease in mental health risks.

CONCLUSIONS

These findings provide valuable insights for policymakers seeking to enhance student mental well-being in rural settings, emphasizing the importance of implementing measures that promote balanced sleep habits among young students.

A Web-Based Resilience-Enhancing Program to Improve Resilience, Physical Activity, and Well-being in Geriatric Population: Randomized Controlled Trial

BACKGROUND

Resilience is a protective factor in healthy aging, helping to maintain and recover physical and mental functions. The Resilience in Illness Model has proven effective in fostering resilience and well-being. Physical activity is crucial for older adults' independence and well-being, even as aging causes a progressive decline. Additionally, older adults face challenges such as spousal loss and physical disability, making preventive intervention strategies necessary.

OBJECTIVE

This study aims to develop and evaluate a web-based program to enhance resilience, physical activity, and well-being among community-dwelling older adults. Additionally, we aim to gather feedback on the program's strengths and limitations.

METHODS

A 4-week resilience-enhancing program was created, incorporating role-play and talk-in-interaction and focusing on 3 key skills: coping, control belief, and manageability. The program included scenarios such as becoming widowed and suffering a stroke, designed to engage older adults. A pilot test preceded the intervention. As a result of the COVID-19 pandemic, the program shifted from in-person to web-based sessions. A single-blind, parallel-group, randomized controlled trial was conducted. Participants aged over 65 years were recruited offline and randomly assigned to either an intervention or control group. A certified resilience practitioner delivered the program. Outcomes in resilience, physical activity, and well-being were self-assessed at baseline (T0), 4 weeks (T1), and 12 weeks (T2) after the program. A mixed methods approach was used to evaluate feedback.

RESULTS

A web-based participatory program enhancing 3 skills-coping, control belief, and manageability for resilience-was well developed. Among 96 participants, 63 were randomized into the intervention group (n=31) and the control group (n=32). The mean age in the intervention group was 69.27 (SD 3.08) years and 74.84 (SD 6.23) years in the control group. Significant between-group differences at baseline were found in age (t45.6=-4.53, P<.001) and physical activity at baseline (t61=2.92, P=.005). No statistically significant between-group differences over time were observed in resilience (SE 7.49, 95% CI -10.74 to 18.61, P=.60), physical activity (SE 15.18, 95% CI -24.74 to 34.74, P=.74), and well-being (SE 3.74, 95% CI -2.68 to 11.98, P=.21) after controlling for baseline differences. The dropout rate was lower in the intervention group (2/31, 6%) compared with the control group (5/32, 16%). Moreover, 77% (24/31) of participants in the intervention group completed the entire program. Program feedback from the participants indicated high satisfaction with the web-based format and mentorship support.

CONCLUSIONS

This study demonstrated that a web-based resilience-enhancing program is appropriate, acceptable, feasible, and engaging for community-dwelling older adults. The program garnered enthusiasm for its potential to optimize resilience, physical activity, and well-being, with mentorship playing a crucial role in its success. Future studies should aim to refine program content, engagement, and delivery methods to effectively promote healthy aging in this population.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05808491; https://clinicaltrials.gov/ct2/show/NCT05808491.

Predicting the level of resilience of adults aged 25-65 relation to the elderly according to their interpersonal problem-solving methods

BACKGROUND

Elderly home caregivers are among the first and most important people involved in elderly care. Since the process of caring for the elderly affects the mental, physical, and life conditions of the caregivers, it is of utmost importance to study interpersonal problem-solving methods and the role they play in the resilience of caregivers. In this regard, the study was conducted to predict the resilience of adults aged 25-65 years compared to the elderly according to their interpersonal problem-solving methods.

MATERIALS AND METHODS

This is a descriptive correlational study. Two-hundred and sixty-two adults aged 25-65 living in Iran in different genders, marital status, majors, and occupations participated in this study. The data obtained from responding to questionnaires of resilience and interpersonal problem solving of respondents were analyzed using Pearson's correlation coefficient and linear regression correlation coefficient.

RESULTS

The findings showed that there is a significant relationship between resilience and some problem-solving methods (frankness and transparency, realism, exposure, sympathy, pursuit and challenge, and incentive agreement) of elderly home caregivers. According to the result of linear regression, among the respondents' interpersonal problem-solving methods, realism was the only predictive variable for resilience (P = 0.006). That is, being more realistic is related to more resilience in caring for the elderly.

CONCLUSIONS

Some interpersonal problem-solving methods of adults are related to their resilience in caring for the elderly. Paying attention to these resilient practices and behaviors can be effective in improving the quality of care for the elderly and reducing their difficulties. The results of this study can be used in long-term and practical planning for elderly home caregivers.

Social Isolation, Loneliness, and Depressive Symptoms Among Older Adults: The Moderating Effect of Resilience

BACKGROUND AND OBJECTIVES

Social isolation has been recognized as a social problem with negative health consequences. Using data from 3 waves of the Health and Retirement Study, this study aimed to examine the long-term impact of social isolation on loneliness and depressive symptoms and to explore the moderating effect of resilience.

RESEARCH DESIGN AND METHODS

This study comprised 3,681 U.S. adults aged 60 and older at the baseline wave. Social isolation index was constructed using 5 indicators, including not married or cohabitating with a partner, no social participation, and less than monthly contacts with children, family members, or friends. Loneliness was measured by the University of California Los Angeles (UCLA) Loneliness Scale and depressive symptoms were measured by the Center for Epidemiological Studies-Depression scale. The moderator of resilience was assessed by the simplified resilience score. Latent growth curve models with robust standard errors were estimated.

RESULTS

The results of latent growth curve models showed that social isolation was significantly associated with more initial loneliness and depressive symptoms. However, social isolation was associated with a slower increasing rate of loneliness, but no significant relationship with the change rate of depressive symptoms. Furthermore, resilience significantly buffered the negative effect of social isolation on the initial level of depressive symptoms.

DISCUSSION AND IMPLICATIONS

The findings underscore the importance of enacting strategies and interventions targeting resilience to address social isolation and its negative consequences among older adults.

The effectiveness of preventive home visits on resilience and health-related outcomes among community dwelling older adults: A systematic review

BACKGROUND

This research aimed to assess the effectiveness of preventive home visits (PHVs) in enhancing resilience and health-related outcomes among older adults living in the community.

METHODS

A comprehensive literature search was conducted in nine databases (PubMed, MEDLINE, CINAHL, Embase, Emcare, Web of Science (WOS), Scopus, PsycINFO and Cochrane Library. The search was undertaken between March 15 and 31, 2022 with subsequent updates performed on October 15, 2023 and April 10, 2024. This review also included grey literature sourced via Google, Google Scholar and backward citation searches.

RESULTS

Out of 5,621 records, 20 articles were found to meet the inclusion criteria with a total of 8,035 participants involved and the mean age ranged from 74.0 to 84.4 years. Using McMaster Critical Review Form for Quantitative Studies, we ascertained that the studies included in our analysis had moderate to high levels of quality. In addition to health-related outcomes, PHV interventions were also conducted to evaluate psychological effects (16 studies) and social outcomes (seven studies). Five studies conducted financial assessment to evaluate the costs of health and social care utilisation during PHV interventions. Regarding the results of the review, seven studies showed favourable outcomes, five indicated no effect and eight had equivocal findings. Only one study assessed resilience and determined that PHV had no effect on the resilience of the subjects.

CONCLUSION

This review found that the effectiveness of PHV interventions was uncertain and inconclusive. PHV interventions often prioritise health-related objectives. The incorporation of a holistic approach involving psychosocial health into PHV interventions is relatively uncommon. Due to the paucity of research on resilience as PHV outcome, we are unable to draw a conclusion on the effectiveness of PHV on resilience. Resilience should be prioritised as a psychological assessment in the future development of comprehensive PHV interventions, as it enables older adults to adapt, manage, and respond positively to adversities that may arise with age. Performing financial analysis such as costs and benefits analysis to incorporate the return on investment of PHV interventions is an added value for future research on this topic.

CLINICAL TRIAL REGISTRATION

PROSPERO registration number: CRD42022296919.

Exploring society-to-cells resilience among community members: A multidisciplinary study in outpatient clinics with diverse participant demographics

AIM

This study explores and understands community members' resilience in outpatient clinics, considering various dimensions and types of resilience.

DESIGN

A cross-sectional study.

METHODS

This study was conducted in Saudi outpatient clinics from September to December 2023 and included 384 individuals chosen through systematic random sampling. Various tools were used, such as Social Cohesion and Trust Scale, Community Resilience Assessment Tool, Community Assessment of Psychic Experiences, Environmental Resilience Assessment, Economic Resilience Index, Connor-Davidson Resilience Scale, Brief Resilience Scale, Resilience Scale for Adults and Healthcare Resilience Index.

RESULTS

Participants displayed a robust overall resilience level, as indicated by Total Connor-Davidson Resilience Scale score of 63.0 ± 9.0. Additionally, they demonstrated commendable levels of resilience in Total Brief Resilience Scale (56.04 ± 8.6), Resilience Scale for Adults (82.5 ± 7.2) and Healthcare Resilience Index (45.8 ± 5.5). These findings offer significant insights into psychological and emotional well-being of the study population, highlighting their adaptive capacities and coping mechanisms across various life domains.

CONCLUSION

This study provides valuable insights into the multidimensional nature of resilience in outpatient settings. The cross-sectional design sets the groundwork for future longitudinal investigations, highlighting the need for a holistic approach to understanding and promoting resilience.

IMPACT

This study holds immediate implications for participants and their communities. It underscores the adaptive capacities and coping mechanisms prevalent in the outpatient population by revealing commendable resilience levels. This insight enhances individuals' psychological and emotional well-being, contributing positively to the overall resilience and communal strength. Additionally, this study sheds light on how resilience among community members in Saudi Arabia relates to international advanced nursing communities, providing insight into their work.

PATIENT OR PUBLIC CONTRIBUTION

Patients who have received outpatient services in the past 6 months were purposively chosen to ensure a diverse representation across age, gender and socio-economic backgrounds in this study.

Interventions that have potential to help older adults living with social frailty: a systematic scoping review

BACKGROUND

The impact of social frailty on older adults is profound including mortality risk, functional decline, falls, and disability. However, effective strategies that respond to the needs of socially frail older adults are lacking and few studies have unpacked how social determinants operate or how interventions can be adapted during periods requiring social distancing and isolation such as the COVID-19 pandemic. To address these gaps, we conducted a scoping review using JBI methodology to identify interventions that have the best potential to help socially frail older adults (age ≥65 years).

METHODS

We searched MEDLINE, CINAHL (EPSCO), EMBASE and COVID-19 databases and the grey literature. Eligibility criteria were developed using the PICOS framework. Our results were summarized descriptively according to study, patient, intervention and outcome characteristics. Data synthesis involved charting and categorizing identified interventions using a social frailty framework.  RESULTS: Of 263 included studies, we identified 495 interventions involving ~124,498 older adults who were mostly female. The largest proportion of older adults (40.5%) had a mean age range of 70-79 years. The 495 interventions were spread across four social frailty domains: social resource (40%), self-management (32%), social behavioural activity (28%), and general resource (0.4%). Of these, 189 interventions were effective for improving loneliness, social and health and wellbeing outcomes across psychological self-management, self-management education, leisure activity, physical activity, Information Communication Technology and socially assistive robot interventions. Sixty-three interventions were identified as feasible to be adapted during infectious disease outbreaks (e.g., COVID-19, flu) to help socially frail older adults.

CONCLUSIONS

Our scoping review identified promising interventions with the best potential to help older adults living with social frailty.

Exploring Factors Associated With Resilience and Physical Activity in Older Men and Women Post-Hip Fracture

This study aimed to test a model of factors associated with resilience and physical activity post-hip fracture and compare model fit between men and women. We used data from the seventh Baltimore Hip Study that included 339 participants. Model testing indicated that health status (men: β = .237, p = .002; women: β = .265, p = <.001), depression (men: β = -.245, p = .001; women: β = -.241, p = <.001), and optimism (men: β = .320, p = <.001; women: β = .282, p = <.001) were associated with resilience in men and women, but resilience was only associated with physical activity in men (β = .203, p = .038) and not in women. Social interaction was related to physical activity only among women (β = .206, p = .044). This study provides support for the relationship between resilience and physical activity at least among men.