Association between resilience and frailty among Chinese older adults

Abstract

PurposeResilience is a multidimensional concept determining healthy aging, however, there were limited studies examining the association between frailty and resilience in detail. In this study, we aimed to examine the association of frailty with three dimensions of resilience-strength, optimism, and tenacity among Chinese older adults.MethodsA cross-sectional study was conducted among 10,209 participants who were sampled by three-stage sampling method, from three cities in China from June 2020 to July 2021. The Chinese version of the Connor–Davidson Resilience Scale (CD-RISC) was used to measure resilience's 3 dimensions (strength, optimism and tenacity), which were converted into quartiles for the analysis. Frailty status was measured using the Chinese version of the FRAIL scale, categorized into robustness, pre-frailty and frailty. Multinomial logistic regression was used to examine associations between frailty status with strength, optimism and tenacity.ResultsThe overall proportions of robustness, pre-frailty, and frailty were 42.7, 48.7, and 8.6%, respectively. After controlling for sociodemographic characteristics, self-rated health, and health behaviors, compared with older adults with the lowest quartile of strength, older adults with the second quartile (odds ratio, OR = 0.67, 95% CI: 0.57–0.78), third quartile (OR = 0.60, 95% CI: 0.50–0.72), and fourth quartile (OR = 0.58, 95% CI: 0.46–0.73) of strength had lower ORs for pre-frailty, and who also had lower ORs (0.44, 95% CI: 0.33–0.58; 0.42, 95% CI: 0.30–0.59; 0.34, 95% CI: 0.20–0.56, respectively) for frailty. There were no homogeneous associations between optimism and tenacity with frailty status.ConclusionHigher strength was associated with lower chance of being pre-frail and frail among Chinese older adults. This finding implies that community-based training programs aiming to enhance psychological resilience, especially strength, may contribute to healthy aging. Future studies should examine the effects of resilience on frailty using longitudinal or experimental study designs in cross-cultural contexts.

Multidimensional Frailty and Lifestyles of Community-Dwelling Older Portuguese Adults

“…As for stress control, it simply is not a cause of social frailty, i.e., resilient and effective stress management translates into less physical and psychological frailty, as we already concluded in the bivariate analysis and described in a recent study [ 48 ].…”

“…A recent study reports that high levels of anxiety and/or depression were associated with frailty and a greater likelihood of adverse outcomes [ 47 ]. Another study reports that positive attitudes towards aging, such as self-esteem, optimism, and resilience, seem to decrease the risk of frailty [ 48 ].…”

The other side of the coin: Dispositional optimism, frailty, and negative life events in aging

“…On the other hand, frailty denotes a common adverse outcome in aging; in fact, frail older adults appear less optimistic, and generally exhibit lower resilience, as previously suggested. 5 Clinical practice and research are increasingly focused on counteracting frailty and promoting factors of resilience. 6 Dispositional optimism may denote the psychological common denominator between these two opposite pathways: optimistic subjects are more likely to reach longevity and, in addition, can exhibit lower levels of frailty.…”