Resilience among older cardiovascular disease patients with probable sarcopenia

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.

Resilience-happiness nexus in community-dwelling middle-aged and older adults: Results from Gan-Dau Healthy Longevity Plan

The core of healthy aging is intrinsic capacity (IC) that consists of major elements, i.e., cognition, locomotion, vitality, sensory capacity, and psychological aspect. This cross-sectional study analyzes data of the Gan-Dau Healthy Longevity Plan, targeting community-dwelling adults aged 50 years or older. The participants completed the assessment, in addition to WHO IC, including the Mini-Mental Status Examination (MMSE) for cognitive performance, 6 m walking speed (m/s),timed up-and-go test (s) and hand grip strength (Kg) for locomotor assessment, Cardiovascular health study (CHS) for frailty assessment, Mini Nutrition assessment short form (MNA-SF) for nutrition. Psychological aspect including the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Geriatric Depression Scale-5 (GDS-5) for depressive symptoms, the Brief Resilience Scale (BRS) for resilience, and the Chinese Happiness Inventory (CHI) for happiness levels. The study enrolled 810 participants (mean age of 68.45 ± 8.05 years, 32% male) and revealed that 94.7% of participants exhibited impairments in IC, with visual capacity and cognition being the most common deficit items of IC. Resilience levels varied, with 37.4% of men and 33.5% of women exhibiting moderate to low resilience. Only 23.4% of male participants and 21.1% female participants reported a high level of happiness. Resilience was found to partially mediate the relationship between intrinsic capacity and happiness, with approximately 6.6% of the variance in happiness being mediated by resilience. In conclusion, the study provides valuable insights into the connections between psychological aspect, IC, and healthy aging.

Quality of life and intrinsic capacity in patients with post-acute COVID-19 syndrome is in relation to frailty and resilience phenotypes

The objective of this study was to characterize frailty and resilience in people evaluated for Post-Acute COVID-19 Syndrome (PACS), in relation to quality of life (QoL) and Intrinsic Capacity (IC). This cross-sectional, observational, study included consecutive people previously hospitalized for severe COVID-19 pneumonia attending Modena (Italy) PACS Clinic from July 2020 to April 2021. Four frailty-resilience phenotypes were built: "fit/resilient", "fit/non-resilient", "frail/resilient" and "frail/non-resilient". Frailty and resilience were defined according to frailty phenotype and Connor Davidson resilience scale (CD-RISC-25) respectively. Study outcomes were: QoL assessed by means of Symptoms Short form health survey (SF-36) and health-related quality of life (EQ-5D-5L) and IC by means of a dedicated questionnaire. Their predictors including frailty-resilience phenotypes were explored in logistic regressions. 232 patients were evaluated, median age was 58.0 years. PACS was diagnosed in 173 (74.6%) patients. Scarce resilience was documented in 114 (49.1%) and frailty in 72 (31.0%) individuals. Predictors for SF-36 score < 61.60 were the phenotypes "frail/non-resilient" (OR = 4.69, CI 2.08-10.55), "fit/non-resilient" (OR = 2.79, CI 1.00-7.73). Predictors for EQ-5D-5L < 89.7% were the phenotypes "frail/non-resilient" (OR = 5.93, CI 2.64-13.33) and "frail/resilient" (OR = 5.66, CI 1.93-16.54). Predictors of impaired IC (below the mean score value) were "frail/non-resilient" (OR = 7.39, CI 3.20-17.07), and "fit/non-resilient" (OR = 4.34, CI 2.16-8.71) phenotypes. Resilience and frailty phenotypes may have a different impact on wellness and QoL and may be evaluated in people with PACS to identify vulnerable individuals that require suitable interventions.

Physical resilience in older adults: Potential use in promoting healthy aging

Physical resilience is a dynamic concept referring to the physiological response when the body is exposed to stressors. The level of physical resilience is the sum of underlying physiological reserves. Moreover, it may not only be determined by age, genetics, or exposure to a variety of diseases, but is also closely related to the psychological, social, and environmental factors of an individual. This paper summarizes our present understanding of the relationship between physical resilience and other concepts closely related to it. Furthermore, we illustrate the current research progress on physical resilience models and clinical resilience assessment. Besides, this paper intends to present a better understanding of physical resilience and its use in treatment decision-making, personalized diagnosis and disease management, and prevention and rehabilitation strategies.

Resilience and Depressive Symptoms in Adults With Cardiac Disease: A Systematic Review

BACKGROUND

Depressive symptoms predict hospitalization and mortality in adults with cardiac disease. Resilience, defined as a dynamic process of positively responding to adversity, could protect against depressive symptoms in cardiac disease. No systematic review has been conducted on the relationship between these variables in this population.

OBJECTIVE

The aim of this review was to explore the association between psychological resilience and depressive symptoms in adults with cardiac disease.

METHODS

Seven databases (PubMed, EMBASE, CINAHL, PsycInfo, Web of Science, SCOPUS, and Cochrane) were searched from inception to December 2019 using the search terms "cardiac disease," "depressive symptoms," "depression," and "resilience." Inclusion criteria dictated that studies reported original research on the association between resilience and depressive symptoms in adults with a cardiac disease broadly defined. Quality ratings were performed by 2 independent raters.

RESULTS

We identified 13 studies for final review. Study sample sizes ranged from 30 to 1022 participants, average age ranged from 52 to 72 years, and all studies had majority male participants (64%-100%). Resilience and depressive symptoms were inversely related in 10 of 13 studies. The 3 studies with poor-quality sampling techniques or significant loss to follow-up found no relationship.

CONCLUSIONS

Resilience seems to protect against depression in adults with cardiac disease. Gaps in the literature include poor understanding of the direction of causality. Methods of promoting resilience need to be identified and studied.

Quantifying Physical Resilience in Ageing Using Measurement Instruments: A Scoping Review

Purpose: The capacity to recover motor function with pathology or age-related decline is termed physical resilience. It is unknown what outcome domains are captured with existing measurement instruments. Thus, this scoping review aimed to identify measurement instruments for physical resilience, identify research gaps, and make recommendations for future research. Methods: Articles were included from the search when their subject matter included the term resilience in relation to the physical health of older adults. Data on physical resilience measurement instruments were extracted using the outcome domains: body function or structure, activity and participation, and societal impact. Results: The majority of the 33 included articles involved older adults with fractures, cardiac conditions, and cancer. Many measurement instruments quantified body function or structure, and some instruments captured activity and participation, and societal impact of physical resilience. Measurement instruments were pooled into 4 categories: psychological, physiological, motor function, and psychosocial scales. No studies combined all areas of measurement. Conclusions: A potential gap of a measurement instrument capturing social aspects of physical resilience was identified. Comprehensive measurement could identify which outcome domains could be targeted to foster resilience. This knowledge might be useful across many health disciplines and contribute to therapeutic decision-making and rehabilitation strategies.

The Moderating Effect of Resilience on Mental Health Deterioration among COVID-19 Survivors in a Mexican Sample

Resilience has been reported to be a protective psychological variable of mental health; however, little is known about its role in COVID-19 survivors. Thus, in this study, we aimed to evaluate the levels of depression, anxiety, stress, traumatic impact, and resilience associated with COVID-19, as well as to investigate the role of resilience as a moderating variable. A sample of 253 participants responded to an online survey; all were previously diagnosed with COVID-19 by a nasopharyngeal swab RT-PCR test, were older than 18 years, and signed an informed consent form. Significant negative correlations were found between resilience and the mental health variables. Higher resilience was significantly related to a lower impact of the event, stress, anxiety, and depression when the number of symptoms was low. Only when the duration of COVID-19 was short and resilience levels were medium or high was psychological distress reduced. Moreover, resilience moderated the effects of COVID-19 on mental health, even if a relapse occurred. The results emphasize the need for interdisciplinary interventions aimed at providing COVID-19 patients with psychological and social resources to cope with the disease, as well as with probable relapses.

Resilience and caregiving ability among caregivers of people with stroke: The mediating role of uncertainty in illness

BACKGROUND

In China, stroke survivors are usually cared for by their family members. However, the caregiving ability of these informal caregivers remain inadequate during the hospitalization of their family members following a sudden onset of a stroke, and this sudden need for care overwhelms caregivers even after the hospital discharge. Therefore, research is required to identify predictors of caregiving ability that could be targeted in future interventions aimed at improving caregiving skills and reducing the burden on caregivers who care for stroke survivors.

MATERIALS AND METHODS

From August 2019 to February 2020, stroke survivors were hospitalized for the first time, and their family caregivers were registered via convenience sampling. Caregiver demographic information, resilience status, uncertainty in illness, caregiving ability, and patients' severity of stroke were measured using standardized questionnaires. Structural equation modeling was used to test the proposed model, where caregiver resilience and stroke severity predicted caregiving ability directly, and uncertainty in illness mediated the association between caregiver resilience and caregiving ability.

RESULTS

A total of 306 dyads were included in the study. The tested model fit the data well (χ² = 118.2, df = 64, RMSEA = 0.053, CFI = 0.946, TLI = 0.923). Statistically significant pathways linked caregivers' resilience status to uncertainty in illness (β = -0.558, S.E. = 0.022, P < 0.01), caregivers' resilience to the status of caregiving ability (β = -0.269, S.E. = 0.013, P < 0.01) and caregivers' uncertainty about the illness to caregiving ability (β = 0.687, S.E. = 0.051, P < 0.01). We also found that caregivers' uncertainty in illness mediated the association between caregivers' resilience and caregiving ability (β = -0.384, S.E. = 0.061, P < 0.01).

CONCLUSIONS

Our structural equation modeling result identified resilience and uncertainty about the illness as predictors of the caregiving ability of informal family caregivers who suffered from care burdens. Supporting family caregivers to build their resilience and reduce illness uncertainty may improve caregiving for stroke survivors.

Prevalence of High Resilience in Old Age and Association with Perceived Threat of COVID-19-Results from a Representative Survey

Little is known about resilience in old age and its manifestation during the COVID-19 pandemic. This study aims to estimate the prevalence of high resilience in the German old age population. We further examine the socio-demographic correlates and whether high resilience reflects on older adults’ perception of the threat posed by COVID-19. The data were derived from a representative telephone survey of n = 1005 older adults (≥65 years) during the first COVID-19 lockdown. Assessments included socio-demographic variables, the perceived threat of COVID-19, and high resilience (Brief Resilience Scale; cutoff: ≥4.31). The association between high resilience and threat from COVID-19 was analyzed using ordinal logistic regression. The study sample had a mean age (SD) of 75.5 (7.1) years, and n = 566 (56.3%) were female. The estimated prevalence of high resilience was 18.7% (95% CI = [16.3; 21.2]). High resilience was more prevalent in the younger age group and participants with higher education levels. High resilience was significantly associated with a lower perception of threat from COVID-19. The results of the representative survey in the German old age population showed that one out of five adults aged 65 years and older had high resilience. Older adults with high resilience tended to feel less threatened by COVID-19. Further research on resilience in old age is needed to support vulnerable groups in the context of care.

A Predictive Study of Resilience and Its Relationship with Academic and Work Dimensions during the COVID-19 Pandemic

BACKGROUND

The aim of the present study was to describe the resilience levels in a Spanish population during the Coronavirus (COVID-19) pandemic and to analyze the existing associations between high resilience and socio-demographic, work, and academic parameters.

METHOD

1176 individuals aged 18-67 years participated in a descriptive cross-sectional study. The participants were administered the 10-item resilience scale developed by Connor-Davidson (CD-RISC-10) and an ad-hoc questionnaire that collected information on socio-demographic, work, and academic variables. Basic descriptive data were used to statistically analyze the data, and a binary logistic regression model was developed incorporating the professional occupation, academic level, whether the respondent worked in emergency services, and whether the respondent had dependents.

RESULTS

Slightly more than a quarter of the participants showed low resilience, almost half reported moderate resilience, and slightly more than a quarter had high resilience. Those who were employed were 2.16-times more likely to have high resilience, whilst those with higher education were 1.57-times more likely. Those working in emergency services were 1.66-times more likely, and those with dependents were 1.58-times more likely to have high resilience.

CONCLUSION

In addition to the relationships found, a need to improve the resilience levels in the population was found.

Cardiovascular disease knowledge, risk factors, and resilience among US veterans with and without post-traumatic stress disorder

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of death in the United States and the leading cause of hospitalization and disability among the US veterans. Information about CVD knowledge and risk factors, and connection between psychological health and CVD among veterans transitioning from the military are limited.

PURPOSE

We examined the existing knowledge of CVD and its risk factors among the US veterans with and without post-traumatic stress disorder (PTSD), and the relationship between knowledge, risk factors, resilience, and PTSD.

METHODS

A total of 104 veterans participated in our study by responding to the Primary Care PTSD Screen for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Heart Disease Fact Questionnaire (HDFQ) knowledge scale, and Connor-Davidson Resilience Scale 10. Data were extracted from the online Qualtrics survey software into SPSS (v. 25) for analysis.

RESULTS

Mean age was 52.3 years, mostly males (85.6%), married (72.1%), employed (54.8%), and with college education. Most were in the Navy or Air Force (72.1%) and served in a war (68.0%). Hypertension, high cholesterol, and obesity were the most common CVD risk factors reported. Average CVD knowledge score was 85%. Marines scored higher on resilience than other branches of the military. Seventeen percent reported having PTSD. The Connor-Davidson Resilience Scale 10 was significantly correlated with the HDFQ in the probable PTSD group (r = .589, p = .013).

IMPLICATIONS FOR PRACTICE

Our study provides information about the knowledge and risk factors of CVD among veterans and insights about interventions needed to improve CV health. Nurse practitioners should assess the CV and psychological health of veterans and screen for PTSD to provide appropriate care and referral.

Benefits of Physical Activity and Its Associations with Resilience, Emotional Intelligence, and Psychological Distress in University Students from Southern Spain

This is a descriptive and cross-sectional study in a sample of 1095 university students from southern Spain. The aim was to identify the frequency of health-fulfilling physical activity engagement reported by participants. Sufficient physical activity was categorized according to whether participants 'achieved minimum recommendations' (≥150 min of moderate physical activity) or 'did not achieve minimum recommendations' (≤150 min of moderate physical activity). Participants were further categorized as: inactive (does not engage in physical activity or sport), engaging in physical activity that is not beneficial to health (≤300 min of moderate physical activity per week) and engaging in physical activity that is beneficial to health (≥300 min of moderate physical activity per week). Possible relationships with psychosocial factors and perceived psychological distress were explored. An ad hoc questionnaire was used to record the time in minutes of physical activity engagement per week. The Connor-Davidson Resilience Scale, the Trait Meta-mood Scale, and Kessler Psychological Distress Scale were also administered. Statically significant differences are shown between the three examined groups: physical inactivity and non-beneficial physical activity; physical inactivity and beneficial physical activity, and; non-beneficial physical activity and beneficial physical activity. Positive and direct correlations were seen with respect to resilience and understanding, and emotional regulation, in addition to negative associations with respect to psychological distress. In conclusion, the more individuals engage in beneficial physical activity, the greater their resilience and emotional management, and the lower their rates of psychological distress.