Why do some older people seem to weather storms and bounce back from setbacks better than others? A recent study finds that several important factors seem to play a strong role in self-rated resilience among nearly 30,000 women 80 and older.
Researchers from The Ohio State University found that higher education and lower stress, along with strong social support, higher self-rated health and lower risk of depression can help older women rebound from even major life events, including death of a partner. Conversely, most older women at greater risk of depression were also more likely to report lower resilience.
The study further confirmed that where someone lives also matters. There was a noticeable difference in resilience scores based on neighborhood socioeconomic status (SES), with lower SES correlating with lower resilience scores. Almost half of the study participants lived in an area with moderate socioeconomic status, and several factors consistently linked to higher resilience only among these women — including living alone and spirituality. Those living in neighborhoods with lower SES were disproportionately affected by psychological stressors like financial issues, family problems, discrimination and limited access to quality health care.
Why this matters
The findings point to interventions health practitioners could adopt to improve the quality of life for older women in their care, according to lead author Jessica Krok-Schoen, assistant professor in health sciences in the School of Health and Rehabilitation Sciences at The Ohio State University. It also has implications for policymakers and community-based programs such as those fostering social engagement.
Krok-Schoen and colleagues analyzed data from the Women’s Health Initiative, an ongoing study since 1991, to identify characteristics associated with higher self-rated resilience, among women whose average age was 84.
“People are living longer, and that’s great in terms of chronological age, but then there is the question, how are they doing?” Krok-Schoen said. “We often put older adults away in our minds and assume they’re living in institutional settings, but 90% are aging in place — so what are some ways that we can connect and support older women who have a lot of life to share and who make many contributions to our society?”
Racial and ethnic similarities, differences exist
The sample of 29,347 women was 91.4% white, 3.7% Black, 1.9% Hispanic and 1.7% Asian. Investigators hoped to find out how race, ethnicity and neighborhood socioeconomic status affected resilience in older women and found that several factors most strongly associated with higher levels of resilience were the same, regardless of race or ethnicity.
Researchers pointed out that racial and ethnic differences in resilience may demonstrate a cross-over effect in older age, related to racial disparities in life expectancy. While Black adults have higher mortality in younger old age (65-74) due to structural racism, that changes after about age 80, when their risk drops significantly below that of white older adults. They hypothesized that ”the population of older Black adults aged ≥80 may be more robust than their white peers, creating a survivorship bias in research.”
The analysis looked for associations between resilience scores and variables that included demographic data, depression and stress, independent engagement in daily living activities, spirituality, social support, significant life events, major illnesses, and lifestyle and diet assessments.
Krok-Schoen noted that the analysis captured data at a single point in time, so there is a chicken-or-egg situation at play: Do these older women feel less stressed, depressed or burdened by ailments as a result of their resilience, or does lower stress, depression and physical pain contribute to a stronger sense of being resilient?
Resilience is not something we either have or not; it’s a process related to adapting, and it fluctuates, according to Krok-Schoen.
By understanding what older women say about their own resilience, experts could develop interventions for this population designed to foster social support, manage stress, reduce depressive symptoms and encourage physical activity, the study authors said.
This analysis used self-reported assessments from Women’s Health Initiative participants; researchers suggested further follow up be conducted using quantitative data.
The study was published in the March 18 issue of the Journals of Gerontology: Series B.