The Gerontologist Advance Access published online on June 23, 2009
The Gerontologist, doi:10.1093/geront/gnp067
Examining Resilience of Quality of Life in the Face of Health-Related and Psychosocial Adversity at Older Ages: What is "Right" About the Way We Age?
2 Department of Clinical, Educational and Health Psychology, Centre for Outcomes Research and Effectiveness, University College London, UK
3 Department of Medicine, Clinical Epidemiology Unit, Karolinska University Hospital, Sweden
4 Clinical Research Centre, Örebro University Hospital, Sweden
5 Department of Primary Care and Social Medicine, Division of Epidemiology, Public Health and Primary Care, Imperial College London, UK
6 Social Science Research Unit, Institute of Education, University of London, UK
1 Address correspondence to Zoe Hildon, Department of Clinical, Educational and Health Psychology, Centre for Outcomes Research and Effectiveness, University College London, 1-19 Torrington Place, London WC1E 7HB, UK. E-mail: z.Hildon{at}UCL.ac.uk
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Abstract |
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Purpose: This article examines resilience at older ages, focusing on the relationships between quality of life (qol) and adversity. Our objectives are to identify (a) the basis of adversity, (b) the characteristics of resilient individuals, and (c) the attributes that attenuate the full impact of adversity. Design and Methods: Resilience is defined as flourishing despite adversity. Analysis is carried out in a subsample of the Boyd Orr cohort (aged between 68 and 82 years) using questionnaire data. Adversity was identified as circumstances that produce a significant average decrease in qol (CASP-19 scores). Participants were classified into resilient and vulnerable groups based on high or low qol (CASP-19 scores dichotomized at the median) in the face of significant adversity. Shared characteristics that define these outcomes are reported. Attributes that attenuate the negative impact of adversity were analyzed using stratified logistic regression. Results: Adversity was typified by functional limitation; life getting worse in the domains of health, stress, and general living circumstances; and experiencing a negative life event. The resilient tended to report fewer multiple adversities. Indicators of protective attributes, which also characterized resilient outcomes relative to qol, included good quality relationships (5.105, confidence interval [CI] 95% 1.323–19.699), integration in the community (10.800, 95% CI 1.227–95.014), developmental coping (3.397, 95% CI 1.079–10.690), and adaptive coping styles (3.211, 95% CI 1.041–9.910). Implication: Overall results indicate that policies that offer access to protection and help minimize adversity exposure where possible will promote resilience.
Keywords: Protection, Sociodemographic factors, Social networks, Community-related factors, Coping
Received December 3, 2008; Accepted March 16, 2009