Resilience and CVD-protective Health Behaviors in Older Women: Examining Racial and Ethnic Differences in a Cross-Sectional Analysis of the Women’s Health Initiative

Abstract

Little is known about the relationship between self-reported psychological resilience (resilience) and health behaviors shown to reduce the risk of cardiovascular disease (CVD). This study examines the associations between resilience and CVD-related risk factors, such as diet, smoking, physical activity, sleep, and alcohol consumption among older American women from diverse backgrounds. Methods: A cross-sectional secondary analysis was conducted on 77,395 women (mean age 77 years, Black (N = 4475, 5.8%), non-Hispanic white (N = 69,448, 89.7%), Latina (N = 1891, 2.4%), and Asian or Pacific Islander (N = 1581, 2.0%)) enrolled in the Women’s Health Initiative Extension Study II. Resilience was measured using an abbreviated version of the brief resilience scale. Multivariable logistic regression models were used to evaluate the association between resilience and health behaviors associated with risk for CVD, while adjusting for stressful life events and sociodemographic information. To test whether these associations varied among racial/ethnic groups, an interaction term was added to the fully adjusted models between resilience and race/ethnicity. Results: High levels of resilience were associated with better diet quality (top 2 quintiles of the Healthy Eating Index 2015) (OR = 1.22 (95% Confidence Interval (1.15–1.30)), adhering to recommended physical activity (≥ 150 min per week) (1.56 (1.47, 1.66)), sleeping the recommended hours per night (7–9) (1.36 (1.28–1.44)), and moderate alcohol intake (consuming alcoholic drink(s) 1–7 days per week) (1.28 (1.20–1.37)). The observed association between resilience and sleep is modified by race/ethnicity (p = 0.03). Conclusion: Irrespective of race/ethnicity, high resilience was associated with CVD-protective health behaviors. This warrants further investigation into whether interventions aimed at improving resilience could increase the effectiveness of lifestyle interventions.

Resilience as a Mediator of the Association between Spirituality and Self-Management among Older People with Chronic Obstructive Pulmonary Disease

“…Behaviorally, patients with high levels of resilience tended to have more health-promoting behaviors (healthy diet, participation in exercise, good medication adherence, lifestyle, adherence to breathing exercises, etc.) [ 39 , 82 , 83 , 84 ], which are the components of self-management. Content-wise, the components of the resilience scale (e.g., self-efficacy, coping skills) have been shown to improve self-management in COPD patients [ 9 , 85 ].…”

The Paradoxical Effect of Living Alone on Cognitive Reserve and Mild Cognitive Impairment among Women Aged 60+ in Mexico City

“…We may speculate that a woman who lives alone comprises one factor representing different dimensions [20]. They are able and used to carrying out household chores by themselves, and they may have overcome widowhood and/or divorce with perhaps more resilience than men [19,20,34,35]. These conditions may favor their sense of autonomy, independence, and functionality, and thus increase their cognitive reserve and decrease their risk of developing cognitive impairment [8,36].…”

Psychological Resilience, Cardiovascular Disease, and Metabolic Disturbances: A Systematic Review

“…Research exploring the relationship of PR with CVD outcomes is still in its infancy, with some studies pointing to an inverse association between PR, CVD, and metabolic conditions ( Topel et al, 2019 ; Kim et al, 2020 ; Springfield et al, 2020 ), while others failed to find any association ( Felix et al, 2019 ; Turkson-Ocran et al, 2020 ). Thus, we performed a systematic review to summarize the available literature that investigated the relationship between PR and CVD or metabolic outcomes.…”