School of Health Sciences, Queen Margaret University, Musselburgh, UK.
Edinburgh Health and Social Care Partnership, NHS Lothian, UK.
Gerontologist. 2022 Oct 19;62(9):e520-e533. doi: 10.1093/geront/gnab110.
Global policy emphasizes the need to promote healthy aging through supporting inclusivity, safety, and functional independence. Research indicates that efforts to enhance resilience can contribute to meeting these objectives. We employed a meta-analytical approach to examine evidence on resilience in community-living older adults.
We searched electronic databases until January 13, 2020 for observational studies investigating factors associated with resilience in this population. Articles had to provide quantitative data based on standardized assessment and include samples where mean participants' age and lower 95% confidence interval were more than 55 years. We included 49 studies reported in 43 articles and completed 38 independent meta-analyses, 27 for personal and 11 for contextual factors associated with resilience.
A range of personal and contextual factors were significantly associated with resilience, with effects sizes predominantly small to moderate (0.1 < r < 0.49). Factors reflecting psychological and physical well-being and access to/quality of social support were associated with higher resilience. Factors indicative of poorer psychological well-being and social challenges were associated with lower resilience. Longitudinal evidence was limited. The level of between-study heterogeneity was substantial to considerable. Where relevant analysis was possible, the identified publication bias was also considerable.
The quality of the available evidence, as well as issues related to measurement of resilience, indicates the need for further work relative to its conceptualization and assessment. The presented findings have important clinical implications, particularly within the context of the coronavirus disease 2019 impact on resilience in older adults.
全球政策强调需要通过支持包容性、安全性和功能独立性来促进健康老龄化。研究表明,增强适应力的努力有助于实现这些目标。我们采用元分析方法来研究社区居住的老年人适应力的证据。
我们检索了电子数据库,截至 2020 年 1 月 13 日,以寻找调查该人群适应力相关因素的观察性研究。文章必须提供基于标准化评估的定量数据,并包括参与者平均年龄和 95%置信区间下限大于 55 岁的样本。我们纳入了 49 项研究,这些研究分别报告在 43 篇文章中,并完成了 38 项独立的元分析,其中 27 项与个人因素相关,11 项与环境因素相关。
一系列个人和环境因素与适应力显著相关,效应大小主要为小到中等(0.1<r<0.49)。反映心理和身体健康以及获得/社会支持质量的因素与较高的适应力相关。反映较差的心理健康和社会挑战的因素与较低的适应力相关。纵向证据有限。研究间的异质性水平相当大。在相关分析可行的情况下,确定的发表偏倚也相当大。
现有证据的质量以及与适应力测量相关的问题表明,需要进一步开展工作以深化对其概念化和评估的理解。研究结果具有重要的临床意义,特别是在 2019 年冠状病毒病对老年人适应力的影响背景下。