Being psychologically resilient can reduce the risk of all-cause mortality

By Priyanjana Pramanik, MSc.Reviewed by Lily Ramsey, LLMSep 6 2024

Psychological resilience may significantly reduce mortality risk in older adults. ​​​​​​

Study: Association between psychological resilience and all-cause mortality in the Health and Retirement Study. Image Credit: Vitezslav Vylicil/Shutterstock.com

In a recent study published in BMJ Mental Health, researchers investigated how psychological resilience can affect the risk of mortality from all causes among older adults living in the United States.

Their findings indicate that as psychological resilience levels increase, the risk of dying significantly decreases, highlighting its importance as a factor that can promote overall health and longevity.

Background

Researchers define psychological resilience as the ability to adapt to and cope with difficult life situations, such as a significant loss or poverty. While some individuals recover well from adversity, others may struggle, leading to psychological challenges.

Resilience is thought to be influenced by factors like genetics and stress regulation mechanisms. In older adults, resilience has been linked to better mental and physical health, helping reduce the negative effects of disability or chronic illness.

Although researchers have found indications that physical resilience can be connected to mortality risk, the relationship between psychological resilience and mortality has not been widely studied.

Limited research suggests resilience may improve survival, but findings are not yet generalizable. Few studies have explored this link among older adults in the United States.

About the study

This study used data from the Health and Retirement Study (HRS), a large, ongoing survey of U.S. adults aged 50 and older.

Researchers aimed to explore associations between mortality and psychological resilience. Data were taken from two waves (2006–2008), which included a special questionnaire on psychological resilience. Of the 19,193 participants, only 10,569 provided complete data, which was used in the final analysis.

The research team measured psychological resilience using a simplified resilience score based on 12 items from a well-known scale. The scores ranged from 0 to 12, with higher scores indicating greater resilience.

Participants were divided into four groups (quartiles) based on their resilience scores. Mortality outcomes were tracked until May 2021 using several reliable methods.

Regression models using Cox proportional hazards (which examine the impact of different factors on the likelihood of an event happening) were used to quantify the association between resilience and mortality, adjusting for demographic factors (age, sex, race), health conditions (diabetes, heart disease, etc.), and lifestyle factors (smoking, physical activity).

The analysis also accounted for the non-linear relationship between mortality and resilience using advanced statistical methods.

Findings

The study analyzed data from 10,569 older adults who were 66.95 years old on average to explore the relationship between psychological resilience and mortality. Participants were followed for an average of 11.6 years, during which 3,489 deaths were recorded.

The participants were divided into four groups based on their resilience scores, and those with higher resilience had significantly better survival rates.

For example, individuals in the highest resilience quartile had an 83.9% survival probability over 10 years, compared to 61% for those in the lowest quartile.

The analysis showed a strong association between higher psychological resilience and a lower risk of death. Even after adjusting for factors like age, sex, race, health conditions, smoking, and physical activity, individuals with the highest resilience scores had a significantly lower risk of mortality.

This trend was consistent across various models and was particularly evident for women. The study also found that the relationship between resilience and cardiovascular mortality was similar to that for all-cause mortality, highlighting the protective effect of resilience on overall health.

Conclusions

This study highlights the significant role psychological resilience plays in reducing the risk of death in older adults.

The findings are relevant as they suggest that higher resilience can improve survival rates, making resilience a potential target for health interventions in aging populations. This builds on existing research but provides more generalizable results due to the large sample size and comprehensive adjustment for several confounding factors.

One of the strengths of this study is its large, nationally representative sample, which allowed for a more detailed analysis than previous research. The long follow-up period of more than ten years and adjustments made for lifestyle and health conditions also strengthen the reliability of the results.

However, some limitations must be considered. The resilience score used may not sufficiently capture how dynamic resilience is, and unmeasured factors, such as genetic influences or early-life experiences, might have impacted the findings.

Moreover, as an observational study, it cannot establish a causal relationship between resilience and mortality.

For future research, studies can explore the effects of resilience using other scales and assess how changes in resilience over time impact health outcomes.

Additionally, investigating how specific components of resilience contribute to longevity could help tailor interventions aimed at improving resilience in aging populations.