Researchers have found that older adults diagnosed with Type 2 Diabetes, (T2D) who had high levels of psychological resilience, were more likely to have better physical functioning, higher quality of life, and a lower likelihood of frailty and self-reported disability.
MedicalNewsToday reports that psychological resilience, or just resilience, depends on people’s ability to respond and adapt to complex events like stress or trauma. It has to do with bouncing back after experiencing hardship, according to the study, published in the Journal of the American Geriatrics Society.
Both internal and external factors impact resilience. People are different, so their levels of resilience are also different. For example, adults with greater levels of social support are more likely to have more robust levels of resilience.
Resilience can also affect how they cope with chronic conditions, like T2D, a chronic metabolic disorder that affects the body’s ability to use glucose for energy.
It requires careful long-term management. If left unmanaged, it can lead to severe health complications like diabetic nephropathy and heart disease. Experts are still researching the best disease management methods and factors influencing long-term health outcomes.
Researchers in this current study wanted to examine how psychological resilience affected health in older adults with T2D.
The study included more than 3 000 older adult participants with T2D. These participants were originally enrolled in a clinical trial that compared different diabetes management interventions. Current study authors followed up with these participants on average 14.5 years later. They measured a few different components among the participants:
• resilience, using the Brief Resilience Scale that relies on self-reporting;
• overnight hospitalisations within the past year;
• physical functioning, including self-reports and looking at gait speed and grip strength;
• physical and mental quality of life;
• frailty, as measured with unintentional weight loss, physical inactivity, low energy, slow gait, and reduced grip strength; and
• depressive symptoms
Overall, researchers found that higher levels of psychological resilience were associated with better health outcomes, including lower numbers of hospitalisations, better physical functioning and quality of life, and fewer symptoms of depression.
Study author KayLoni Olson, PhD, of Brown Medical School, Providence, pointed out the following highlights of the Look AHEAD Trial to MNT: “We found that among older adults with Type 2 diabetes, individuals who reported a greater degree of psychological resilience (being able to ‘bounce back’ after stress) also reported better overall ageing-related health. This includes metrics like fewer hospitalisations in the previous year, lower likelihood of meeting criteria for frailty, and greater mental well-being.”
However, they also found some variation between the association of resilience with some metrics. They note that this indicates that “some associations may differ based on race (or) ethnicity”.
Study limitations
This particular study had a few limitations indicating the need for more in-depth research. First, the study cannot determine causality. It was also a cross-sectional study, which means that the authors could not determine the directional relationship of the variables.
Other limitations are related to particular study and analysis methods. For example, they did not look at all of the sociocultural factors that may impact resilience. They also didn’t examine specific aspects of ageing, like cognitive function. Most participants were white and female, which can limit the generalisation of the study’s findings.
Anamara Ritt-Olson, PhD, an associate professor of health, society and behaviour at the School of Public Health at the University of California, Irvine, who was not involved in the study, said: “Resilience is the armour that we wear to weather the difficulties of life and allows to come out relatively unharmed.
“The study findings suggest that when older adults build their resiliency, they will find benefits it both their mental and physical strength. They may even be able to avoid hospitalisations.
“The research also offers insight into the important relationship between the mind and the body. Further research can confirm the impact of psychological resilience and provide longer-term follow-up.
“The current study can’t tell us if psychological resilience causes better overall health or vice versa, which means that additional research is important for teasing these relationships apart,” she noted.
Study details
Psychological resilience in older adults with type 2 diabetes from the Look AHEAD Trial
KayLoni L. Olson, Marjorie Howard, Jeanne McCaffery, Gareth Dutton, Mark Espeland et al.
Published in the Journal of the American Geriatrics Society on 5 October 2022
Abstract
Background
There is growing interest in identifying factors associated with healthy ageing. This cross-sectional study evaluated associations of psychological resilience with factors associated with ageing in older adults with type 2 diabetes mellitus (T2DM).
Methods
Participants were 3199 adults (72.2 ± 6.2 years of age, 61% female, 61% White, body mass index [BMI] = 34.2 ± 8.2 kg/m2) with T2DM enrolled in Look AHEAD (a multi-site randomised clinical trial comparing an intensive lifestyle intervention for weight loss to diabetes education and support). Participants were followed observationally after the 10-year intervention was discontinued. The following items were assessed approximately 14.4 years post-randomisation in a cross-sectional analysis: Brief Resilience Scale; overnight hospitalisations in past year; physical functioning measured objectively (gait speed, grip strength) and via self-report (Pepper Assessment Tool for Disability; physical quality of life [QOL; SF-36]); a measure of phenotypic frailty based on having ≥3 of unintentional weight loss, low energy, slow gait, reduced grip strength, and physical inactivity. Depressive symptoms (PHQ-9) and mental QOL (SF-36) were also measured. Logistic/linear/multinomial regression was used to evaluate the association of variables with resilience adjusted for age, race/ethnicity, and gender.
Results
Greater psychological resilience was associated with lower BMI, fewer hospitalisations, better physical functioning (i.e., lower self-reported disability, better physical QOL, faster gait speed, greater grip strength, lower likelihood of frailty), fewer depressive symptoms, and greater mental QOL (all p < 0.05). Psychological resilience moderated the relationship of number of hospitalisations in the past year with self-reported disability and grip strength.
Conclusions
Psychological resilience is associated with better physical function and QOL among older adults. Results should be interpreted cautiously given cross-sectional nature of analyses. Exploring the clinical benefits of resilience is consistent with efforts to shift the narrative on ageing beyond “loss and decline” to highlight opportunities to facilitate healthy ageing.
See more from MedicalBrief archives:
Self-monitoring of type 2 diabetes cuts follow-up costs by more than half
Dairy products may protect against type 2 diabetes – Italian meta-analysis
Evaluating grip strength as a screening tool to identify risk of early diabetes