Resilience in Older People: A Concept Analysis

Multiple domain resilience components and frailty, postoperative complications, and one year quality of life deterioration after pancreatectomy in older patients

The number of older adults is growing rapidly worldwide, and many surgical diseases are prevalent in this population. Resilience, the ability to adapt positively to adversity, remains a multisystemic process with no standardized objective measurement methods. The aim of this study was to identify the association between resilience components and frailty, postoperative complications, and quality of life changes after pancreatectomy in older patients. This study evaluated older patients (aged ≥ 65) scheduled for pancreatectomy between August 2020 and December 2023. Patients who underwent a Comprehensive Geriatric Assessment and signed informed consent were included. Frailty was determined by multidimensional frailty score more than 5. Neurohumoral resilience was measured using the ACTH stimulation test, cardiovascular autonomic function using orthostatic blood pressure measurement, and cognitive-motor function using dual-task gait tests. The primary outcome was postoperative complications, and the secondary outcome was the deterioration in quality of life one year after pancreatectomy. A total of 57 patients were included in the analysis. Among them, 17 (29.8%) were classified as frail, 10 patients (17.5%) experienced postoperative complications, and 12 patients (24.5%) had worsened quality of life after one year. Low blood pressure and slow usual gait speed was associated with frailty. Diminished cortisol responsiveness correlated with frailty and postoperative complications. Quality of life deterioration was associated with differences between dual-task (serial 7) gait speed and fast gait speed. This study highlights the potential association between multidomain resilience components, frailty, and clinical outcomes in older patients undergoing pancreatectomy. Future research should focus on developing robust, objective, and reliable resilience metrics for clinical use.

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.

Turkish validation of a resilience scale from older people's perspectives: resilience scale for older adults

Background

As the global population ages and life expectancy increases, older adults encounter challenges like chronic illnesses and losing loved ones; resilience is crucial for adapting to these difficulties. This study aims to culturally and linguistically adapt the psychological resilience scale designed for older adults to the Turkish context.

Methods

This methodological study included 566 individuals aged 65 and older. All participants completed the Resilience Scale for Older Adults, the Perceived Stress Scale, the Geriatric Depression Scale, and the Quality of Life in Older Adults Scale-Short Form. Construct validity was assessed through confirmatory and exploratory factor analyses, while convergent and discriminant validity were evaluated through the correlation of the scales. Reliability was determined using internal consistency and the split-half method.

Results

The scale retains its original structure with 33 items and four sub-dimensions (Intrapersonal, Interpersonal, Spiritual, and Experiential). The content validity index of the scale is 0.98, with item loadings ranging from 0.406 to 0.947, according to exploratory factor analysis. Confirmatory factor analysis indicates good fit indices. Convergent validity is supported by a strong positive correlation (r = 0.657, p < 0.001) between the Resilience Scale for Older Adults and the Quality of Life in Older Adults Scale-Short Form. Reliability measures include a Cronbach's alpha internal consistency coefficient of 0.93 and a Guttman split-half reliability coefficient of 0.723.

Conclusion

The results show that the Turkish version of the Resilience Scale for Older Adults is a valid and reliable measurement tool.

Optimizing lung cancer surgery in the elderly: sublobar resection versus lobectomy for early-stage non-small cell lung cancer patients aged 80 and above

The optimal surgical approach for elderly patients with early-stage non-small cell lung cancer (NSCLC) remains a topic of debate. A retrospective analysis was conducted on patients who underwent pulmonary resection for early-stage NSCLC at our single institution between January 2018 and December 2022. Propensity score matching was used to balance baseline characteristics between the sublobar resection and lobectomy groups. Perioperative outcomes, pulmonary function recovery, postoperative quality of life, and survival were compared between the two groups. A total of 151 patients were included, with 42 undergoing sublobar resection and 109 undergoing lobectomy. After propensity score matching, baseline characteristics were well-balanced between the two groups. Sublobar resection was associated with shorter operative time (125.83 ± 33.56 min vs. 161.14 ± 61.54 min, p = 0.048), less intraoperative blood loss [65 (30, 75) ml vs. 120 (70, 170) ml, p < 0.001], shorter drainage duration [3 (2, 5) days vs. 5 (3, 6) days, p < 0.001], shorter hospital stay [6 (4, 8) days vs. 10 (7, 13) days, p < 0.001], and fewer postoperative complications (11.9% vs. 47.6%, p < 0.001), compared to lobectomy. Moreover, sublobar resection led to better pulmonary function recovery and higher postoperative quality of life scores, with no significant difference in overall and disease-free survival between the groups. Sublobar resection in patients aged 80 and above with early-stage NSCLC offered comparable oncological outcomes to lobectomy while preserving more lung function and providing better postoperative recovery and long-term quality of life. These findings have important implications for treatment decision-making in elderly NSCLC patients.

Navigating the Shadows: A Comprehensive Review of Suicide in the Geriatric Population

This review critically examines the complex landscape of suicide within the geriatric population, defined as individuals aged 65 and older. By synthesizing existing research, we elucidate critical findings related to the prevalence, risk factors, and challenges associated with suicide in this demographic. Social isolation, mental health issues, and the intricate psychosocial dimensions of ageing emerge as pivotal factors contributing to the vulnerability of older individuals. The conclusion underscores a compelling call to action, urging collaborative efforts from healthcare professionals, policymakers, and communities to implement targeted prevention strategies. Our vision for the future involves building a supportive and resilient community for the geriatric population, emphasizing age-friendly policies, robust social support networks, and destigmatizing mental health discussions. Through this comprehensive exploration, we aim to contribute to a deeper understanding of suicide in the geriatric population and inspire effective interventions that prioritize the well-being and dignity of older individuals.