The association between psychological resilience and cognitive function in longitudinal data: Results from the community follow-up survey

Combined associations of cognitive impairment and psychological resilience with all-cause mortality in community-dwelling older adults

BACKGROUND

Cognitive impairment and psychological resilience are closely related in older adults, but their combined effect on mortality has not been reported. Using a nationally representative sample from the Chinese Longitudinal Healthy Longevity Study, this study examined the interactions between cognitive impairment and psychological resilience and their associations with overall survival.

METHODS

A total of 32,349 community-dwelling older adults (86.85 ± 11.16 years, 56.06 % female) were enrolled in 1998, 2000, 2002, 2005, 2008, 2011, and 2014; all participants were followed until 2018. Cognitive function and psychological resilience were assessed using the Mini-Mental State Examination (MMSE) and the 7-item psychological resilience questionnaire (PRQ), respectively. Illiterate subjects with an MMSE score <18, or literate subjects with an MMSE score <24 were defined as having cognitive impairment. Cox proportional risk regressions were used to analyze the association of cognitive impairment and psychological resilience with all-cause mortality.

RESULTS

After 146,993.52 person-years of follow-up, 23,349 older adults died. Both MMSE and PRQ scores (as continuous variables) were negatively associated with mortality risk after adjusting for all covariates. The hazard ratio (HR) of all-cause mortality for cognitive impairment was not significantly moderated by levels of psychological resilience (P-interaction = 0.094). In joint analyses, participants with combined cognitive impairment and low resilience (by the median of PRQ: < 25 points) had the highest risk of mortality (adjusted-HR: 1.56, 95%CI: 1.48-1.61), which was higher than that of patients with either condition alone. There was a significant additive interaction effect of cognitive impairment and low resilience on all-cause mortality (relative excess risk due to interaction: 0.11, 95 % CI: 0.09-0.13), and 7 % of the overall mortality risk was attributable to their synergistic effect.

CONCLUSIONS

Cognitive impairment and low resilience are synergistically associated with increased risk of all-cause mortality in community-dwelling older adults. The potential mechanisms underlying this combined effect warrant further exploration.

Childhood experiences and sleep problems: A cross-sectional study on the indirect relationship mediated by stress, resilience and anxiety

BACKGROUND

Childhood experiences either adverse (ACE) or benevolent (BCE) can indirectly impact sleep quality in adult life, which in turn are modulated by the interplay of a variety of factors such as depression, anxiety, resilience and mental health problems.

METHODS

A cross-sectional observational study was conducted across the UK and the Middle Eastern countries during the COVID-pandemic on 405 participants. An online survey used a combination of questionnaires to assess ACE and BCEs. The following tools were then used to assess the contribution of resilience, stress, depression and anxiety respectively: Brief Resilience Scale (BRS), Perceived Stress Scale (PSS-10), Patient Health Questionnaire-2 (PHQ-2) and General Anxiety Disorder-2 (GAD-2) scale on childhood experiences. The extent of sleep disturbances experienced over a period of seven days was assessed using the PROMIS Sleep Disturbance Short-Form Tool. A serial-parallel mediation model was used to evaluate the impact of the mediators on childhood experiences and sleep quality.

RESULTS

Over 50% of the cohort were from Middle Eastern countries. Four or more BCEs were experienced by 94.3% of the cohort. In contrast, 67.9% of participants experienced at least one ACE before the age of 18 years, with moderate levels of stress, mild depression and anxiety were reported in 3.7%, 13% and 20% of participants respectively. Whilst 25.4% of participants reported having had four or more ACEs, with higher reports in the middle easter countries (32%). ACEs were found to correlate with sleep disturbance whilst BCEs showed an inverse correlation. The relationship between ACE and sleep disturbances was shown to be mediated by stress, and anxiety, but not by resilience or depression. Resilience and stress, and resilience and anxiety serially mediated the interaction between ACE and sleep disturbance. With regards to BCE, an inverse association with sleep disturbance was recorded with similar mediators of stress and anxiety observed.

CONCLUSION

This study confirms the negative effects of ACEs, and the positive effects of BCEs on sleep in adulthood which are both mediated predominantly by psychological resilience, anxiety and stress. Strategies aimed at improving psychological resilience as well as addressing stress and anxiety may help improve sleep quality.

Association of psychological resilience and cognitive function in older adults: Based on the Ma' anshan Healthy Aging Cohort Study

OBJECTIVES

The purpose of this study was to explore whether psychological resilience can influence changes in cognitive function in older adults and provide clues and rationale for improving cognitive function and preventing the onset of dementia in the geriatric population.

METHODS

A total of 2495 older adults aged 60 years or older from the Ma' anshan Healthy Aging Cohort were included in the study. Participants' cognitive functioning and psychological resilience were measured using the MMSE (mini-mental state examination) scale and the SRQS (stress resilience quotient scale) scale during the 5 years of follow-up, and the association was explored. Those with MMSE scores ≤ 17 in the illiterate group, ≤ 20 in the elementary school group, and ≤ 24 in the secondary school and above group were considered cognitive impairment.

RESULTS

The prevalence of cognitive impairment increased from 6.89% to 14.30% during the five years of follow-up. At 5-year follow-up, the group with the highest psychological resilience had 41 (6.83%) individuals whose cognitive functioning changed from normal to cognitive impairment, while the group with the worst psychological resilience had 114 (18.33%) individuals. The study also found a significant effect of different levels of psychological resilience on changes in cognitive functioning after adjusting for potential confounders. Compared with Q1 (the reference group), the Odds ratio of cognitive decline in Q2, Q3 and Q4 groups were 0.51(0.42,0.64), 0.37(0.29,0.47) and 0.19(0.13,0.27), respectively.

CONCLUSIONS

Improving the level of psychological resilience in older adults may be one way to prevent the incidence of cognitive impairment.

Sex differences in the mediating effect of resilience on social support and cognitive function in older adults

This study assessed the social support-cognitive function relationship in older Chinese Han adults by sex, while examining the mediating effect of resilience. Community-dwelling participants (60-94 years, M = 70.85 ± 7.31; n = 333) completed questionnaires assessing social support, resilience, and cognitive function. The mediating effect of resilience by sex was tested through structural equation modeling. Cognitive function was lower in older age groups (70-79 and ≥80 years). In structural equation modeling, social support positively predicted cognitive function, while resilience mediated this relationship in both sexes. In men, alongside the direct contribution of objective support, the relationship between subjective support and cognitive function was completely mediated by tenacity. In women, tenacity partially mediated this relationship, whereas subjective support directly predicted cognitive function. This study provides evidence of the mediating effect of resilience in the social support-cognitive function relationship among older Chinese adults, revealing important sex differences.

Life-Satisfaction, Engagement, Mindfulness, Flourishing, and Social Support: Do they Predict Depression, Suicide Ideation, and History of Suicide Attempt in Late Life?

OBJECTIVE

Suicide is an outcome arising from a combination of risk and protective factors. Examining psychological resilience traits associated with successful aging may help to better understand late-life suicide and depression. We examined self-reported protective factors including mindfulness, life satisfaction and engagement, flourishing, and subjective and objective social support in a high suicide-risk sample of depressed older adults.

METHODS

Participants were 297 individuals aged 55+ (mean age: 64.2): 92 depressed suicide attempters, 138 depressed individuals who never attempted suicide, and 67 non-psychiatric comparisons. Using linear and binomial logistic regression, we examined the effects of a combined Protective Factor value on presence and severity of depression and suicidal ideation, and history of suicide attempt.

RESULTS

Relative to the non-psychiatric comparison group, all depressed participants had significantly lower Protective Factor values. Higher Protective Factor value was associated with lower likelihood of depression, depression severity, and likelihood of ideation, but was not associated with ideation severity or history of suicide attempt. Participants with one standard deviation higher Protective Factor had lower odds of ideation incidence by a factor of OR=0.68 (95%CI=0.48-0.96).

CONCLUSION

Resiliency characteristics relevant to psychological wellbeing and successful aging may mitigate the emergence of depression and suicidal ideation, as well as the severity of depression in late-life. The Resilience Factor used in this study can help clinicians nuance their appraisal of depression and suicide risk.

Interindividual Variability in Mental Fatigue-Related Impairments in Endurance Performance: A Systematic Review and Multiple Meta-regression

BACKGROUND

The negative effect of mental fatigue (MF) on physical performance has recently been questioned. One reason behind this could lie in the interindividual differences in MF-susceptibility and the individual features influencing them. However, the range of individual differences in mental fatigue-susceptibility is not known, and there is no clear consensus on which individual features could be responsible for these differences.

OBJECTIVE

To give an overview of interindividual differences in the effects of MF on whole-body endurance performance, and individual features influencing this effect.

METHODS

The review was registered on the PROSPERO database (CRD42022293242). PubMed, Web of Science, SPORTDiscus and PsycINFO were searched until the 16th of June 2022 for studies detailing the effect of MF on dynamic maximal whole-body endurance performance. Studies needed to include healthy participants, describe at least one individual feature in participant characteristics, and apply at least one manipulation check. The Cochrane crossover risk of bias tool was used to assess risk of bias. The meta-analysis and regression were conducted in R.

RESULTS

Twenty-eight studies were included, with 23 added to the meta-analysis. Overall risk of bias of the included studies was high, with only three presenting an unclear or low rating. The meta-analysis shows the effect of MF on endurance performance was on average slightly negative (g = - 0.32, [95% CI - 0.46; - 0.18], p < 0.001). The multiple meta-regression showed no significant influences of the included features (i.e. age, sex, body mass index and physical fitness level) on MF-susceptibility.

CONCLUSIONS

The present review confirmed the negative impact of MF on endurance performance. However, no individual features influencing MF-susceptibility were identified. This can partially be explained by the multiple methodological limitations such as underreporting of participant characteristics, lack of standardization across studies, and the restricted inclusion of potentially relevant variables. Future research should include a rigorous description of multiple different individual features (e.g., performance level, diet, etc.) to further elucidate MF mechanisms.

Associations between Sleep, Depression, and Cognitive Performance in Adolescence

The relevance of cognitive performance during adolescence requires further studies that analyze potential associated factors. This study aimed to analyze inductive reasoning, reading comprehension, and mathematical thinking (problem-solving and number and calculation) in relation to sleep and depression in 244 students aged 12-17 years (47.6% boys and 52.4% girls). Daytime sleepiness, sleep quality, dysthymia, and euthymia (state and trait) were assessed by self-reported questionnaires. Moreover, correlations between these variables and cognitive performance, and differences depending on sociodemographic variables (sex, age, or academic year) were analyzed using non-parametric tests. Robust regression models were also conducted to evaluate the predictive role of significant variables on cognitive performance. The results showed significant bidirectional relationships between sleep- and depression-related variables, and between the latter ones and cognitive performance. Depression-trait was more related to cognitive performance than depression-state, and euthymia more than dysthymia, but neither daytime sleepiness nor sleep quality significantly correlated with it. As for sociodemographic variables, girls reported worse sleep and more depressive symptoms than boys did, and younger students reported better sleep but performed worse than the older ones. Although these findings should be further explored in forthcoming studies adding other promising variables, they highlight the importance of promoting euthymia to improve cognitive performance in adolescents.

Association of social network properties with resilience and depression among community-based Korean population

We aimed to determine how the properties of social networks relate to resilient-related status. This cross-sectional study used baseline data from the Cardiovascular and Metabolic Disease Etiology Research Center cohort and included 11,132 participants. Ego-centric social network size and intimacy were used to reflect social network properties. Resilient-related status was operationally defined based on the participant's response to the Life Experience Survey and the Back Depression Inventory Ⅱ. Participants were categorized into three groups: reference (no negative life event; no depression), resilient (with negative life event; but no depression), and depression (no/with negative life event; with depression). Multinomial logistic regression models were used to estimate the association of social networks on the resilient-related status after adjusting for all covariates. Social network size was positively associated with the resilient group for both sex (male: OR = 1.01 [95% CI = 0.96 to 1.05], female: OR = 1.07 [95% CI = 1.03 to 1.11]), whereas intimacy showed a negative association (male: OR = 0.91 [95% CI = 0.82 to 1.01], female: OR = 0.84 [95% CI = 0.76 to 0.92]). Additionally, as each social network property increased, the likelihood of being categorized as belonging to the depression group decreased, regardless of age and sex.

Overseas Chinese Returnees' Swindler Syndrome and Their Entrepreneurial Education Under Psychological Resilience

The study aims to explore the entrepreneurship education of overseas Chinese returnees with the swindler syndrome through psychological resilience. First, a questionnaire survey is conducted to analyze the current situations of entrepreneurship education of overseas Chinses returnees and college students, and it is found that the entrepreneurship education received by overseas Chinese returnees is more advanced and perfect than that by domestic students, which makes overseas Chinese returnees have the ability to solve the problems in the process of entrepreneurship, realizing their entrepreneurial dream. However, the emergence of swindler syndrome changes the self-awareness and psychology of these returnees, which is improved through appropriate entrepreneurship education under resilience analysis. The results show that entrepreneurial resilience and entrepreneurial optimism covered by psychological resilience have a significant positive impact on entrepreneurial intention, indicating that entrepreneurial resilience and entrepreneurial optimism can enhance individual’s entrepreneurial intention. The scores of the subjects with the experience of studying abroad are higher than those without such experience, indicating that overseas Chinese returnees have stronger resilience and more optimistic attitudes in the face of difficulties and setbacks, which provides a new perspective for in-depth analysis of Chinese returnees’ entrepreneurship education and promotes the development of entrepreneurship education in colleges and universities in China.