Resilience in old age : physical performance and psychosocial factors in changing sociohistorical contexts and as resources in adversities

Abstract

Resilience refers to the process of adapting to adversity, and it may play an important role in aging well. The key features of resilience are adversity, outcome and resources enabling adaptation. The interplay between the individual and environmental factors over the life course may shape the appearance of resilience. This study explored whether sociohistorical changes influence later life physical performance by comparing two cohorts born 28 years apart. The role of physical performance and psychosocial factors was explored in two adversity contexts: as predictors of mortality after a bone fracture and as predictors of maintaining a high QoL during social distancing because of the COVID-19 pandemic. This study utilized data generated in two study projects. The Evergreen cohort (n=617) was linked to information on the incidence of bone fractures and mortality for 15 years after baseline. The baseline measurements were repeated in the Active Aging – Resilience and External Support as Modifiers of the Disablement Outcome (AGNES) cohort (n=1 021) and the participants were followed up on using the AGNES-COVID-19 survey (n=809). The participants were initially 75-, 80-, or 85-year-old community-dwelling people. The later-born cohort had higher walking speed and muscle strength compared with the earlier born cohort. The associations of lower walking speed and muscle strength with mortality hazard were pronounced during the first postfracture year compared with a situation without fracture exposure. Better walking speed increased the odds for maintaining a high QoL only among those who perceived the social distancing recommendations as restrictive. Better stress coping ability and not perceiving oneself as lonely increased the odds for maintaining a high QoL, regardless of how restrictive the recommendations were perceived to be. Mortality after a bone fracture and likelihood of maintaining a high QoL during social distancing recommendations did not differ between those living versus not living alone. The results showed improved physical performance (i.e., resources) among the later-born cohort, which is most likely a result of more propitious life course exposures. In addition, this study suggests that in old age, physical performance measures may reflect the underlying physiologic and functional reserves to respond effectively to adversities.