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Wister A, Klasa K, Linkov I. A Unified Model of Resilience and Aging: Applications to COVID-19. Front Public Health 2022; 10:865459. [PMID: 35685765 PMCID: PMC9170899 DOI: 10.3389/fpubh.2022.865459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/21/2022] [Indexed: 11/18/2022] Open
Abstract
Drawing on multidisciplinary research focusing on a spectrum ranging from individual experience to structural system-level risk response and resilience, this article develops a rationale for a Unified Model of Resilience and Aging (UMRA). In response to a broad range of adversities associated with aging, it details the ways in which some individuals are able to bounce back better than others, or adapt better than expected, termed resilience. However, resilience and aging theoretical models have developed out of different disciplinary developments, ranging from individual levels to structural level complex systems, including several gerontological theoretical models addressing adaptation to life course and aging processes. The article reviews and synthesizes prior conceptual and theoretical work, and their empirical groundings, in order to develop an integrated resilience model with wide applications to aging-related problems including chronic illness, mental health, widowhood, poverty, caregiving burden, etc. The article focuses specifically on COVID-19 pandemic risk, response and resilience in order to specify applications of the UMRA, and to suggest avenues for future research and testing of theoretical axioms.
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Affiliation(s)
- Andrew Wister
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
- *Correspondence: Andrew Wister ; orcid.org/0000-0002-0045-7428
| | - Katarzyna Klasa
- University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Igor Linkov
- United States Army Corps of Engineers, Engineering Research and Development Center, Vicksburg, MS, United States
- Carnegie Mellon University, Pittsburg, PA, United States
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Wister A, Li L, Cosco TD, McMillan J, Griffith LE. Multimorbidity resilience and COVID-19 pandemic self-reported impact and worry among older adults: a study based on the Canadian Longitudinal Study on Aging (CLSA). BMC Geriatr 2022; 22:92. [PMID: 35109803 PMCID: PMC8808267 DOI: 10.1186/s12877-022-02769-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/14/2022] [Indexed: 01/07/2023] Open
Abstract
Background The Coronavirus Disease-2019 (COVID-19) pandemic has created a spectrum of adversities that have affected older adults disproportionately. This paper examines older adults with multimorbidity using longitudinal data to ascertain why some of these vulnerable individuals coped with pandemic-induced risk and stressors better than others – termed multimorbidity resilience. We investigate pre-pandemic levels of functional, social and psychological forms of resilience among this sub-population of at-risk individuals on two outcomes – self-reported comprehensive pandemic impact and personal worry. Methods This study was conducted using Follow-up 1 data from the Canadian Longitudinal Study on Aging (CLSA), and the Baseline and Exit COVID-19 study, conducted between April and December in 2020. A final sub-group of 9211 older adults with two or more chronic health conditions were selected for analyses. Logistic regression and Generalized Linear Mixed Models were employed to test hypotheses between a multimorbidity resilience index and its three sub-indices measured using pre-pandemic Follow-up 1 data and the outcomes, including covariates. Results The multimorbidity resilience index was inversely associated with pandemic comprehensive impact at both COVID-19 Baseline wave (OR = 0.83, p < 0.001, 95% CI: [0.80,0.86]), and Exit wave (OR = 0.84, p < 0.001, 95% CI: [0.81,0.87]); and for personal worry at Exit (OR = 0.89, p < 0.001, 95% CI: [0.86,0.93]), in the final models with all covariates. The full index was also associated with comprehensive impact between the COVID waves (estimate = − 0.19, p < 0.001, 95% CI: [− 0.22, − 0.16]). Only the psychological resilience sub-index was inversely associated with comprehensive impact at both Baseline (OR = 0.89, p < 0.001, 95% CI: [0.87,0.91]) and Exit waves (OR = 0.89, p < 0.001, 95% CI: [0.87,0.91]), in the final model; and between these COVID waves (estimate = − 0.11, p < 0.001, 95% CI: [− 0.13, − 0.10]). The social resilience sub-index exhibited a weak positive association (OR = 1.04, p < 0.05, 95% CI: [1.01,1.07]) with personal worry, and the functional resilience measure was not associated with either outcome. Conclusions The findings show that psychological resilience is most pronounced in protecting against pandemic comprehensive impact and personal worry. In addition, several covariates were also associated with the outcomes. The findings are discussed in terms of developing or retrofitting innovative approaches to proactive coping among multimorbid older adults during both pre-pandemic and peri-pandemic periods. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02769-2.
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Affiliation(s)
- Andrew Wister
- Gerontology Research Centre & Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada.
| | - Lun Li
- Gerontology Research Centre, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada
| | - Theodore D Cosco
- Gerontology Research Centre & Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada.,Oxford Institute of Population Ageing, University of Oxford, 66 Banbury Road, Oxford, OX2 6PR, UK
| | - Jacqueline McMillan
- Department of Medicine, Section of Geriatric Medicine, University of Calgary, Calgary, AB, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Lauren E Griffith
- Labarge Centre for Mobility in Aging, McMaster University, Hamilton, ON, Canada.,McMaster Institute for Research on Aging, McMaster University, Hamilton, ON, Canada.,Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Social Determinants and Health Behaviours among Older Adults Experiencing Multimorbidity Using the Canadian Longitudinal Study on Aging. Can J Aging 2021; 41:327-347. [DOI: 10.1017/s0714980821000544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract
This study examines associations between lifestyle behavioural factors and appraisals of “healthy aging” among older adults experiencing multimorbidity. A Social Determinants and Health Behaviour Model (SDHBM) is used to frame the analyses. Using baseline data from the Canadian Longitudinal Study on Aging (CLSA), we studied 12,272 Canadians 65 years of age or older who reported 2 or more of 27 chronic conditions. Additional analyses were conducted using three multimorbidity clusters: cardiovascular/metabolic, musculoskeletal, and mental health. Using hierarchical logistic regression, it was found that, for multmorbidity and the three illness clusters, healthy aging is consistently associated with not smoking (except for the mental health cluster), an absence of obesity (except for the cardiovascular and metabolic cluster), better sleep, and a better appetite. It is not associated with inactivity. Several socio-demographic, environmental, and illness covariates were also supported. The findings are examined using the SDHBM coupled with a resilience lens in order to elucidate how modifiable health behaviours can act as resources to mitigate multimorbidity adversities. This has implications for healthy aging for persons with multimorbidity, especially during the COVID-19 pandemic.
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da Silva-Sauer L, de la Torre-Luque A, Smith BW, C M C Lins M, Andrade S, Fernández-Calvo B. Brief Resilience Scale (BRS) Portuguese Version: validity and metrics for the older adult population. Aging Ment Health 2021; 25:1554-1563. [PMID: 32299220 DOI: 10.1080/13607863.2020.1753015] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study aims to analyze the psychometric properties of the new Brazilian-Portuguese version of the Brief Resilience Scale (B-BRS) in older adults. METHOD A sample of 1251 participants (54.20% women; M = 68.02 years, SD = 6.52) completed the B-BRS and seven scales on successful aging and mental health. Confirmatory factor analysis was used to study the B-BRS dimensionality. Convergent and divergent validity was analyzed by means of examining the relationships of B-BRS with scales on successful aging and mental health. RESULTS The results supported the unidimensionality of the B-BRS after controlling for wording method, as well as satisfactory reliability (ω = .79). B-BRS structure remained invariant across education level and income groups. B-BRS scores positively correlated with successful aging factors and negatively with psychopathology symptoms. CONCLUSION To conclude, our findings provide some evidence on the reliability and validity of the B-BRS, as well as its validation for use in the senior population.
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Affiliation(s)
- Leandro da Silva-Sauer
- Laboratory of Aging and Neurodegeneration, Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Alejandro de la Torre-Luque
- Center for Biomedical Research in Mental Health (CIBERSAM). Department of Psychiatry, Autonomous University of Madrid, Madrid, Spain
| | - Bruce W Smith
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Mônica C M C Lins
- Laboratory of Aging and Neurodegeneration, Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Suellen Andrade
- Laboratory of Aging and Neurodegeneration, Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Bernardino Fernández-Calvo
- Laboratory of Aging and Neurodegeneration, Department of Psychology, Federal University of Paraiba, Joao Pessoa, Brazil
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Klasa K, Galaitsi S, Wister A, Linkov I. System models for resilience in gerontology: application to the COVID-19 pandemic. BMC Geriatr 2021; 21:51. [PMID: 33446109 PMCID: PMC7807229 DOI: 10.1186/s12877-020-01965-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 12/15/2020] [Indexed: 01/10/2023] Open
Abstract
The care needs for aging adults are increasing burdens on health systems around the world. Efforts minimizing risk to improve quality of life and aging have proven moderately successful, but acute shocks and chronic stressors to an individual's systemic physical and cognitive functions may accelerate their inevitable degradations. A framework for resilience to the challenges associated with aging is required to complement on-going risk reduction policies, programs and interventions. Studies measuring resilience among the elderly at the individual level have not produced a standard methodology. Moreover, resilience measurements need to incorporate external structural and system-level factors that determine the resources that adults can access while recovering from aging-related adversities. We use the National Academies of Science conceptualization of resilience for natural disasters to frame resilience for aging adults. This enables development of a generalized theory of resilience for different individual and structural contexts and populations, including a specific application to the COVID-19 pandemic.
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Affiliation(s)
- Katarzyna Klasa
- University of Michigan School of Public Health, Ann Arbor, USA
| | - Stephanie Galaitsi
- United States Army Corps of Engineers, Engineering Research and Development Center, Vicksburg, USA
| | - Andrew Wister
- Gerontology Research Centre, Simon Fraser University, Burnaby, Canada.
| | - Igor Linkov
- United States Army Corps of Engineers, Engineering Research and Development Center, Vicksburg, USA
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Galaitsi SE, Keisler JM, Trump BD, Linkov I. The Need to Reconcile Concepts that Characterize Systems Facing Threats. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:3-15. [PMID: 32818299 DOI: 10.1111/risa.13577] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/05/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
Desirable system performance in the face of threats has been characterized by various management concepts. Through semistructured interviews with editors of journals in the fields of emergency response and systems management, a literature review, and professional judgment, we identified nine related and often interchangeably used system performance concepts: adaptability, agility, reliability, resilience, resistance, robustness, safety, security, and sustainability. A better understanding of these concepts will allow system planners to pursue management strategies best suited to their unique system dynamics and specific objectives of good performance. We analyze expert responses and review the linguistic definitions and mathematical framing of these concepts to understand their applications. We find a lack of consensus on their usage between interview subjects, but by using the mathematical framing to enrich the linguistic definitions, we formulate comparative visualizations and propose distinct definitions for the nine concepts. We present a conceptual framing to relate the concepts for management purposes.
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Affiliation(s)
- S E Galaitsi
- U.S. Army Corps of Engineers, 696 Virginia Rd, Boston, Concord, MA, 01742
| | | | - Benjamin D Trump
- U.S. Army Corps of Engineers, 696 Virginia Rd, Boston, Concord, MA, 01742
| | - Igor Linkov
- U.S. Army Corps of Engineers, 696 Virginia Rd, Boston, Concord, MA, 01742
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Health behaviors and multimorbidity resilience among older adults using the Canadian Longitudinal Study on Aging. Int Psychogeriatr 2020; 32:119-133. [PMID: 31088579 DOI: 10.1017/s1041610219000486] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Recently, there has been a growing interest in examining forms of illness-related resilience. This study examines associations between lifestyle behavioral factors and multimorbidity resilience (MR) among older adults. METHODS Using baseline data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we studied 6,771 Canadian adults aged 65 or older who reported two or more of 27 chronic conditions, and three multimorbidity clusters: cardiovascular/metabolic, osteo-related, and mental health. Associations were explored using hierarchical linear regression modeling, controlling for sociodemographic, social/environmental, and illness context covariates. RESULTS Among older adults with two or more illnesses, as well as the cardiovascular/metabolic and osteo-related illness clusters, having a non-obese body mass, being a non-smoker, satisfaction with quality of sleep, having a good appetite, and not skipping meals are associated with MR. However, the mental-health cluster resulted in different behavioral lifestyle associations, where MR was not associated with obesity, smoking, or appetite, but inactivity demonstrated moderate positive associations with MR. DISCUSSION While there are similar patterns of lifestyle behaviors across multimorbidity and multimorbidity clusters involving physiological chronic illnesses, those associated with mental health are distinct. The results have implications for healthy aging among persons coping with multimorbidity.
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Palma Candia O, Hueso Montoro C, Martí-García C, Fernández-Alcántara M, Campos-Calderón CP, Montoya Juárez R. Understanding the Occupational Adaptation Process and Well-Being of Older Adults in Magallanes (Chile): A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3640. [PMID: 31569804 PMCID: PMC6801773 DOI: 10.3390/ijerph16193640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/05/2022]
Abstract
Background: Aging and longevity are important topics nowadays. Purpose: To describe how older adults perform the occupational adaptation process in the extreme region of Magallanes (Chile), and to identify the factors that might contribute to successful occupational adaptation and well-being. Method: Qualitative study, with a phenomenological interpretative approach. In-depth interviews were carried out with 16 older adults, with high or low levels of well-being, assessed with the Ryff Scale. An inductive content analysis according to Elo and Kyngäs was performed. Findings: Resilience, self-esteem and interdependence with significant others are key elements that promote well-being. Participants develop strategies to minimize the effects of environmental factors. The occupation's function in terms of socialization, use of time, and social participation is revealed as a conditioning factor of occupational adaptation. Implications: Interventions with older people to achieve a successful occupational adaptation process must take into consideration the commitment to meaningful activities.
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Affiliation(s)
| | | | | | - Manuel Fernández-Alcántara
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain.
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Cosco TD, Kok A, Wister A, Howse K. Conceptualising and operationalising resilience in older adults. Health Psychol Behav Med 2019; 7:90-104. [PMID: 34040841 PMCID: PMC8114384 DOI: 10.1080/21642850.2019.1593845] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/06/2019] [Indexed: 11/08/2022] Open
Abstract
Context: As a result of increases in life expectancy and decreases in fertility, the proportion of the population entering later life has increased dramatically in recent decades. When faced with age-related challenges, some older adults respond more positively to adversity than would be expected given the level of adversity that they have experienced, demonstrating 'resilience'. Objectives: Having a clear conceptual framework for resilience is a prerequisite to operationalising resilience in a research context. Methods: Here we compare and contrast several approaches to the operationalisation of resilience: psychometric-driven and data-driven (variable-centred and individual-centred) methods. Results: Psychometric-driven methods involve the administration of established questionnaires aimed at quantifying resilience. Data-driven techniques use statistical procedures to examine and/or operationalise resilience and can be broadly categorised into variable-centred methods, i.e. interaction and residuals, and individual-centred methods, i.e. categorical and latent class. Conclusions: The specific question(s) driving the research and the nature of the variables a researcher intends to use in their adversity-outcome dyad will largely dictate which methods are more (or less) appropriate in that circumstance. A measured approach to the ways in which resilience is investigated is warranted in order to facilitate the most useful application of this burgeoning field of research.
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Affiliation(s)
- Theodore D Cosco
- Gerontology Research Center, Simon Fraser University, Vancouver, Canada
- Oxford Institute of Population Ageing, Oxford University, Oxford, UK
| | - Almar Kok
- Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Andrew Wister
- Gerontology Research Center, Simon Fraser University, Vancouver, Canada
| | - Kenneth Howse
- Oxford Institute of Population Ageing, Oxford University, Oxford, UK
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Calero MD, Navarro E. Variables that favour successful ageing / Variables que favorecen un envejecimiento exitoso. STUDIES IN PSYCHOLOGY 2018. [DOI: 10.1080/02109395.2018.1506307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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