Expressive Flexibility and Dispositional Optimism Contribute to the Elderly's Resilience and Health-Related Quality of Life during the COVID-19 Pandemic

Development and initial validation of the Mount Sinai Resilience Scale

OBJECTIVE

The construct of psychological resilience has received increasing attention in the mental health field. This article describes the development and initial validation of a novel self-report resilience scale, which addresses gaps in the resilience measurement literature by assessing thoughts and behaviors that help promote resilience rather than traits, and simultaneously evaluating multiple factors previously associated with resilience.

METHOD

Following consensus meetings focused on scale development, we conducted an online study (n = 1,864) of U.S. adults to develop and validate an initial version of the Mount Sinai Resilience Scale (MSRS).

RESULTS

An exploratory factor analysis in a random 50% of the sample suggested a seven-factor solution; this solution was then generally supported by a follow-up confirmatory factor analysis in the remaining 50% of the sample. After removing poor-fitting items, a revised 24-item scale correlated in the expected directions with established measures of perceived resilience and resilience-related constructs (e.g., social support and optimism).

CONCLUSIONS

Collectively, the results of this study provide initial support for the convergent and discriminant validity of the MSRS and describe its factor structure. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perceived risk, illness perception and dispositional optimism related to COVID-19 among oncologic outpatients undergoing in-hospital treatments and healthy controls

OBJECTIVE

This study aimed to explore risk estimations (perceived risk, dispositional optimism) related to COVID-19 perception and distress in oncologic outpatients undergoing active hospital treatments compared to the general population.

DESIGN AND MAIN OUTCOME MEASURES

Data were collected during the Italian lockdown on 150 oncologic outpatients and a sample of 150 healthy subjects. They completed a battery of questionnaires including the Perceived Risk scale, the Brief Illness Perception Questionnaire, the Life Orientation Test- Revised and the Patient Health Questionnaire-4. Descriptive statistics, correlation analysis, and a moderated mediation model were performed to test the study hypotheses.

RESULTS

The moderated mediation model attested significant conditional indirect associations of both clinical status and dispositional optimism with distress through the mediation of COVID-19 perceived risk. Healthy individuals and less optimistic people were more likely than others to report higher psychological distress only when they showed neutral or negative COVID-19-related illness perception.

CONCLUSIONS

Cancer patients manifest a lower risk perception and a more positive illness representation related to COVID-19 compared to control subjects; the distress level is not associated with the clinical status, but it is moderated by illness perception. Adequate protective behaviors in cancer patients may avoid a dangerous underestimation of objective risks.

Exploring the Role of Resilience and Optimism during the COVID-19 Pandemic in Older European Adults

This study examined how resilience and optimism were related to psychological well-being among older European adults during the early pandemic. The study used data sampled from the Eurofound COVID-19 survey conducted in 27 European countries during the first lockdown (April 2020). The study sample included 10,674 older adults (mean age = 69.71 ± 5.15, 68.6% women, 87.3% retired). Using structural equation modeling, the relationship between pandemic adversities, resilience, optimism, and well-being was investigated. Results indicated that resilience and optimism in part mediated the association between adversities and psychological well-being. Resilience and optimism have the potential to help older adults cope with stressful life events and other adversities. Future studies should more precisely explore the role of resilience and optimism, its formation, and the protective mechanisms that promote the psychological well-being of older adults.

The status of e-learning, personality traits, and coping styles among medical students during the COVID-19 pandemic: a cross-sectional study

Objective

The objective of this study was to explore the learning preferences and habits of medical students during the pandemic home e-learning, and to investigate the incidence of adverse emotions, optimistic character level and coping style. To explore the influencing factors of adverse emotions.

Methods

A cross-sectional survey was conducted in China from March to June 2022. Medical students were recruited from three universities in China, and a questionnaire survey was conducted. The questionnaires consisted of a "e-learning preferences and habits questionnaire", life orientation test questionnaire (LOT-R), and simple coping style questionnaire (SCSQ). Finally, a total of 492 medical students who met the inclusion and exclusion criteria became the research subjects and completed the survey.

Results

A total of 57.7% believed they experienced no adverse emotions during home e-learning. ① During the COVID-19 pandemic, the score of optimistic personality of medical students was (7.25 ± 1.933), and the score of pessimistic personality was (5.82 ± 2.240). The score of positive coping was (21.75 ± 5.379), and the score of negative coping was (11.75 ± 3.611). ② The occurrence of medical students' adverse emotions during e-learning was influenced by "Whether there is a private, quiet space to study", "Degree of knowledge mastery", "Physical discomfort or not", "Keep a regular schedule or not", "Optimistic personality tendency".

Conclusion

This study demonstrates the during home e-learning, most medical students have their own learning equipment and can meet their learning needs. Their favorite mobile device to use is a mobile phone, and their favorite method of teaching is to provide course playback. More than half of medical students believe that they have some inconvenience in conducting research during home e-learning. With regard to teacher's real-time screen, the largest number of medical students support teachers turning on live screens so that they feel like they are interacting with the teacher. The preference for blended teaching is highest among medical students. In general, medical students were highly adaptive of the newest e-learning approach. Based on the statistic analysis, the factors that "Whether there is a private, quiet space to study", "Degree of knowledge mastery", "Physical discomfort or not", "Keep a regular schedule or not", and "Optimistic personality tendency" may be the influencing factors for the occurrence of adverse emotions.

The relationship between psychological resilience and depression among the diabetes patients under the background of "dynamic zero COVID-19": the mediating role of stigma and the moderating role of medication burden

Objective

Depression in diabetes patients is caused by their own disease or the surrounding social environment. How to cope with changes in mentality and adjust psychological stress responses, especially under China's dynamic zero COVID-19 policy, is worth further discussion. The researchers constructed a moderated mediation model to test the effect of psychological resilience during dynamic zero COVID-19 on depression in diabetes patients and the mediating role of stigma and the moderating effect of medication burden.

Method

From June to September, 2022, data were collected in Jinghu District, Wuhu City, Anhui Province, by multi-stage stratified sampling. Firstly, we selected a tertiary hospital randomly in Jinghu District. Secondly, departments are randomly chosen from the hospital. Finally, we set up survey points in each department and randomly select diabetes patients. In addition, we used the Connor-Davidson Elasticity Scale (CD-RISC) to measure psychological resilience of patients, and used the Stigma Scale for Chronic Illness (SSCI) to measure stigma, medication burden was measured by the Diabetes Treatment Burden Scale (DTBQ), and depression was assessed by the Patient Health Questionnaire-9 (PHQ-9). We used SPSS (version 23.0) and PROCESS (version 4.1) for data analysis.

Results

(1) Psychological resilience was negatively correlated with stigma, medication burden, and depression. Stigma was positively associated with medication burden and depression. Medication burden and depression are positively correlated, (2) The mediation analysis showed that psychological resilience had a direct predictive effect on depression, and stigma partially mediated the relationship, and (3) Medication burden moderates the direct pathway by which psychological resilience predicts depression; Medication burden moderates the first half of "psychological resilience → stigma → depression."

Conclusion

Under the mediating effect of stigma, psychological resilience can improve depression. Medication burden has a moderating effect on the relationship between psychological resilience and depression, and it also has a moderating effect on the relationship between psychological resilience and stigma. These results facilitate the understanding of the relationship mechanisms between psychological resilience and depression.

Age and gender differences in expressive flexibility and the association with depressive symptoms in adolescents

Objective

This study investigated age and gender differences in the ability to flexibly enhance and suppress facial expressions according to situational demands, known as expressive flexibility (EF), as well as its relationship with depressive symptoms in adolescents.

Methods

The participants included 766 Chinese high school students aged between 12 and 18 years (mean age = 14.96 years, standard deviation = 2.04; 52.2% female). Data on EF and depressive symptoms were collected using self-report questionnaires.

Results

Girls scored higher on enhancement abilities than boys, but with no significant gender difference in suppression abilities. There were also no significant age-related differences in enhancement and suppression abilities. Only enhancement ability was negatively associated with depressive symptoms.

Conclusion

The development of EF abilities was stable among adolescents, with varying effects in terms of gender, and the importance of EF and enhancement abilities in reducing depressive symptoms in adolescents was highlighted.

Adaptive responding to prolonged stress exposure: A binational study on the impact of flexibility on latent profiles of cognitive, emotional and behavioural responses to the COVID-19 pandemic

The high level of uncertainty brought about by the COVID-19 pandemic has affected the general population's well-being and capacity for adaptive responding. Studies indicate that flexibility, defined as the ability to choose and employ a variety of emotional, cognitive and behavioural strategies in accordance with changing contextual demands, may significantly contribute to adaptive responding to long-term stressors such as COVID-19. In the current study, we aimed to investigate which facets of flexibility predict different latent profiles of adaptive responding to the COVID-19 pandemic in Israel and Germany. A total of 2330 Israelis and 743 Germans completed online questionnaires measuring cognitive and coping regulatory flexibility and cognitive, emotional and behavioural responding to the COVID-19 pandemic. Analyses revealed three distinct response profiles in each country (high, medium and low). These profiles differed in both anxiety and depression symptoms with the non-adaptive response group experiencing clinically relevant symptoms both in Israel and Germany. Additionally, cognitive flexibility and coping flexibility emerged as significant predictors of response profiles in both countries. Training cognitive and coping flexibility may thus help individuals respond more adaptively to psychosocial stressors such as COVID-19. Such training could be selectively administered to less flexible subpopulations as well as adapted to the specific population characteristics.

Health-Related Quality of Life and Mental Well-Being during the COVID-19 Pandemic in Five Countries: A One-Year Longitudinal Study

This study aimed to investigate socioeconomic and health-related determinants and recent life events and their relation to changes in health-related quality of life (HRQoL) and mental well-being during the first year of the COVID-19 pandemic. A web-based survey was administered repeatedly to participants from Greece, Italy, the Netherlands, the United Kingdom, and the United States. Primary outcome measures were HRQoL (measured by EQ-5D-5L) and mental well-being (measured by WHO-5). Linear regression analyses were performed to estimate the impact of determinants on HRQoL and well-being. In total, 6765 respondents completed the questionnaire at T1 (April-May 2020) and T2 (May-June 2021). Regarding results, 33% showed improved HRQoL at T2, whereas 31% deteriorated. In terms of mental well-being, 44% improved and 41% deteriorated. The greatest deterioration in HRQoL and mental well-being from T1 to T2 was observed with an increasing number of chronic conditions. The effect of negative life events on HRQoL and mental well-being was larger than the effect of positive life events. We conclude that slightly more respondents showed improved rather than deteriorated HRQoL and mental well-being, with some variation by outcome measure and country.

Emotion regulation strategies and difficulties in older adults: A systematic review

OBJECTIVES

The purpose of this systematic review was to assess the types of emotion regulation (ER) strategies used and difficulties in emotion regulation experienced by older adults, within the theoretical frameworks proposed by Gross, and by Gratz and Roemer, respectively.

METHODS

A systematic search was conducted using principal electronic scientific databases (PubMed, Scopus, and Web of Science). The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines.

RESULTS

The final number of articles included was 44. Older adults reported a higher use of adaptive ER strategies, as well as fewer difficulties in ER, compared with younger adults. Findings from this review also suggest that the use of maladaptive ER strategies can also expose older adults to psychological distress, and may affect their adaptation to negative disease-related outcomes more common in later life.

CONCLUSIONS

Older adults generally showed a greater emotional control compared with younger subjects. Adaptive control strategies, rather than maladaptive control strategies, were correlated with more positive outcomes for psychological distress and adaptation to chronic diseases.

CLINICAL IMPLICATIONS

Understanding the nature of ER processes in older adults may contribute to implement tailored interventions aimed at reinforcing adaptive ER processes.

Optimism and subjective well-being in nursing home older adults: The mediating roles of gratitude and social support

OBJECTIVES

To examine the level of subjective well-being (SWB) and the mediating roles of gratitude and social support in the relationship between optimism and SWB amongst older Chinese people in nursing homes.

METHODS

A total of 354 older adults in Chinese nursing homes completed the World Health Organization's well-being index, Life Orientation Test-Revised, Gratitude Questionnaire-Six-Item Form, and Multidimensional Scale of Perceived Social Support. Structural equation modeling was used to evaluate the relationships between optimism, gratitude, social support and SWB.

RESULTS

The mean SWB score of the older people was (63.14 ±15.31), with 21.0% of subjects reporting low SWB. Gratitude and social support in serial partially mediated the relationship of optimism with SWB (total indirect effect: Standardized β = 0.157, 95% CI [0.109,0.216], p<0.001).

CONCLUSION

These findings provide good evidence for the inter-relationship mechanism amongst the protective factors of SWB, suggesting the need to prioritize positive psychological nursing interventions to promote SWB in older people in residential care.

Expressive flexibility and health-related quality of life: The predictive role of enhancement and suppression abilities and relationships with trait emotional intelligence

This study aims to examine the ability to flexibly enhance and suppress emotional expression, known as expressive flexibility, in relation to physical and psychological health, as well as trait emotional intelligence (EI). A sample of 503 Italian (M_age  = 28.65 ± 9.26 years, 85.1% females) participants completed the Italian version of Flexible Regulation of Emotional Expression (FREE) Scale, the TEIQue-SF, and the Short Form-12 Health Survey. Confirmatory factor analysis indicated that the Italian version of FREE showed adequate psychometric properties. In both genders, results of correlational analyses indicated that enhancement ability was associated with well-being, emotionality, and sociability, whereas suppression ability was associated with self-control. Regression analyses, controlling for age and gender, indicated that suppression and inversely enhancement abilities, predicted the perceived psychological but not physical health. Well-being, self-control, and sociability also contributed to explaining variance in the model. The interaction effect of enhancement and suppression was not significantly associated with either physical or psychological health. Overall, these results suggest that enhancement and suppression abilities differentially contribute to psychological health when trait EI is accounted for. Clinical implications and future directions for research on expressive flexibility are discussed.

Differential Effects of Optimism and Pessimism on Adolescents' Subjective Well-Being: Mediating Roles of Reappraisal and Acceptance

Prior research has found the differential strength of optimism and pessimism in predicting physical health. However, whether similar findings would be obtained in predicting subjective well-being and the possible underlying mechanisms are still unclear. This study examined the relative strength of optimism and pessimism in predicting adolescent life satisfaction and depression, and further explored the possible mediating mechanisms from the perspective of emotion regulation. A sample of 2672 adolescents (M_age = 13.54 years, SD = 1.04; 55.60% boys) completed a survey assessing optimism and pessimism, the habitual use of reappraisal and acceptance strategies, life satisfaction, and depression. The results from dominance analysis revealed that the presence of optimism was more powerful than the absence of pessimism in predicting adolescent life satisfaction, while the absence of pessimism was more powerful than the presence of optimism in predicting adolescent depression. Moreover, mediation models showed that reappraisal and acceptance mediated both the link between optimism and life satisfaction and the link between pessimism and depression. These findings suggest possible avenues for intervening in different aspects of adolescent subjective well-being.

Optimism as a protective factor against the psychological impact of COVID-19 pandemic through its effects on perceived stress and infection stress anticipation

The 2019 coronavirus disease (COVID-19) and the recommended social isolation presented a challenge to people's mental health status. Optimism is a psychological factor that plays a key role in the evaluation of stressful situations. The purpose of this study was to investigate the mediating role of perceived stress and Covid-19-related stress anticipation in the relationship between optimism and post-traumatic stress symptoms. Our sample included 1015 participants ranging in age from 18 to 79 years, 80% of whom were Spaniards. At the beginning of the worldwide pandemic, participants were confined to their homes for at least seven days and completed an online survey measuring various sociodemographic and psychological variables. We found an indirect effect of optimism on intrusion and hyperarousal through perceived stress and stress anticipation. In addition, we observed an indirect effect of optimism on avoidance through perceived stress. Finally, the results showed a significant indirect effect of optimism on the total post-traumatic stress symptoms score through perceived stress and stress anticipation. Our results indicate that positive beliefs inherent to optimism are related to less psychological impact of the COVID-19 outbreak.

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)

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.

Expressive Flexibility and Mental Health: The Mediating Role of Social Support and Gender Differences

Recent research has emphasized the crucial role of expressive flexibility in mental health. This study extended prior studies by further exploring the mediating mechanism and possible gender differences underlying the association between expressive flexibility and mental health indexed by depression and life satisfaction based on the dual-factor model of mental health. Specifically, we explored whether social support mediated the association between expressive flexibility and depression as well as life satisfaction, and whether there were gender differences in these relationships. A total of 711 voluntary college students (mean age = 20.98 years, SD = 2.28; 55.70% women) completed a set of scales assessing expressive flexibility, perceived social support, depression, and life satisfaction. Results showed that expressive flexibility had a positive direct effect on life satisfaction and social support mediated this association. Social support also mediated the relationship between expressive flexibility and depression. The mediation effect of social support was robust and consistent in men and women whereas expressive flexibility had a stronger direct effect on depression in women compared to men. The present study contributes to clarifying the relationship between expressive flexibility and mental health from a more comprehensive perspective. Last, the strengths and limitations of this study were discussed.

Association between the dispositional optimism and depression in young people: a systematic review and meta-analysis

The objective of this study was to perform a meta-analysis of publications that reported the association between dispositional optimism and depression during youth, analyzing if the strength of this relationship varied according to potential factors. Systematic searches were carried out in APA PsycNet, Virtual Health Library, Embase, Web of Science, PubMed Central, and Scopus to collect English, Portuguese, or Spanish studies from 2009 onwards. Two reviewers selected the eligible articles, assessed the quality of each study, and extracted the data. For the synthesis of the results, a meta-analytic approach was used. We identified 4077 publications in the initial searches and 22 in the supplementary searches, from which 31 studies remained for analysis once the eligibility criteria were applied. The results showed a statistically significant negative association between dispositional optimism and depression in the young population, age being a factor that modifies the effect measure between these variables. This meta-analysis provides a consistent and robust synthesis on the interaction effect between dispositional optimism and depression in the young population. Based on these findings, early clinical admissions may effectively improve optimistic tendencies in young people, which could help them prevent depressive symptoms or episodes.

(Dis)Connecting Through COVID-19: Experiences of Older Persons in the Context of a Volunteer-Client Relationship

The coronavirus (COVID-19) pandemic and mandated physical distancing requirements significantly impacted volunteer programs for older persons with many long-standing programs either ceasing altogether or pivoting to connecting through virtual technologies. In this study, we collected qualitative interview data from 23 clients and 33 volunteers to investigate their experiences during the COVID-19 pandemic and the effects on the volunteer-client relationship. Three themes were identified: pandemic emotions, negotiating social interactions, and growing through the COVID-19 pandemic. These findings provide important insights into the experiences of hospice organizations and their volunteers and clients during the COVID 19 pandemic, further highlighting the importance of acknowledging both older persons' vulnerability and their resilience, of building in compassionate community approaches to care, and of finding innovative ways to foster volunteer-client relationships during times when physical visiting is not possible.

Does Reflection on Everyday Events Enhance Meaning in Life and Well-Being among Emerging Adults? Self-Efficacy as Mediator between Meaning in Life and Well-Being

In recent years, the issue of the meaning in life has aroused particularly great interest in researchers considering the question of whether and how, using simple interventions, outside the therapeutic office, the sense of meaning in life and well-being can be strengthened. The aim of this study was to explore whether interventions based on reflection on everyday, stressful situations can contribute to fostering the sense of meaning in life and psychological well-being among emerging adults. Additionally, we aimed to explore relationships between the above-mentioned constructs and self-efficacy. The research focuses on emerging adults, who, as statistics show, are the most vulnerable among all adults to various mental problems. A pretest–posttest control group design was used. The study involved 80 emerging adults (56 women and 24 men) who were randomly assigned to the experimental group, which completed specially prepared diaries for a week, or the control group. Participants completed the Meaning in Life Questionnaire, the Generalised Self-Efficacy Scale, and the Ryff Scales of Psychological Well-Being twice. In the experimental group, significant differences were noted between pretest and posttest in psychological well-being, especially in the area of relationships with others (M_pretest = 59.3; M_posttest = 65.07; t(39) = −11.40; p = 0.001) and purpose in life (M_pretest = 54.85; M_posttest = 58.21; t(39) = −3.15; p = 0.003), as well as self-efficacy (M_pretest = 28.06; M_posttest = 29.60; t(39) = −2.82; p = 0.007). There were no differences in the level of meaning in life. The analysis carried out showed that self-efficacy mediates the relationship between presence of meaning in life and psychological well-being (the Aroian test: z = 4.48; SE = 0.11; p = 0.0007).

Confinement Situation of the Spanish Population during the Health Crisis of COVID-19: Resilience Mediation Process in the Relationship of Dispositional Optimism and Psychological Well-Being

The pandemic generated by COVID-19 is one of the most complex challenges humanity has faced in recent years. This study aims to explore the levels of dispositional optimism, resilience and psychological well-being in the sociodemographic and economic situation produced during the state of alarm and to investigate the resilience mediation between optimism and psychological well-being. The sample included 566 volunteers from Spain (73.5% women; M = 40.2 years, SD = 12.8). An ad hoc questionnaire was applied to request socioeconomic data and dispositional optimism (LOT-R). Resilience and psychological well-being were, respectively, evaluated by the Ryff scale and the Wagnild and Young scale. The results show that older and people with higher educational levels are more optimistic and have better psychological well-being. Well-being is also greater in married, divorced and widowed people and in those who have lived in outdoor spaces. However, those with spaced housing were more optimistic. Finally, it was found that the most optimistic people have better psychological well-being and that this is increased by the mediation process exercised by the ability to overcome adversity, provided age and educational level are controlled. It can be concluded that the design of preventive programs focused on improving strengths, positive emotions and skills in the population would be convenient to protect mental health.

A Clinical Bridge between Family Caregivers and Older Adults: The Contribution of Patients' Frailty and Optimism on Caregiver Burden

The association between caregiver burden and the physical frailty of older adults has been the object of previous studies. The contribution of patients’ dispositional optimism on caregiver burden is a poorly investigated topic. The present study aimed at investigating whether older adults’ multidimensional frailty and optimism might contribute to the burden of their family caregivers. The Caregiver Burden Inventory was used to measure the care-related burden of caregivers. The multidimensional frailty status of each patient was evaluated by calculating a frailty index, and the revised Life Orientation Test was used to evaluate patients’ dispositional optimism. The study involved eighty family caregivers (mean age 64.28 ± 8.6) and eighty older patients (mean age 80.45 ± 7.13). Our results showed that higher frailty status and lower levels of optimism among patients were significantly associated with higher levels of overall burden and higher burden related to the restriction of personal time among caregivers. Patients’ frailty was additionally associated with caregivers’ greater feelings of failure, physical stress, role conflicts, and embarrassment. Understanding the close connection between patient-related factors and the burden of caregivers appears to be an actual challenge with significant clinical, social, and public health implications.