McClennen Taylor, Sharma Hari, Kiel Douglas P, Fortinsky Richard H, Guild Camelia P, Orwig Denise, Magaziner Jay, Binder Ellen F, Berry Sarah D
University of Massachusetts, T.H. Chan School of Medicine, Worcester, Massachusetts, USA.
Hebrew SeniorLife, Hinda and Arthur Marcus Institute for Aging Research and Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
J Gerontol A Biol Sci Med Sci. 2025 May 5;80(6). doi: 10.1093/gerona/glaf008.
High psychological resilience is associated with improved functional outcomes for older adults recovering from hip fractures. The objective of this study was to identify factors associated with increased psychological resilience in older women after hip fracture.
In total, 129 women aged ≥65 years with recent surgically repaired hip fractures were enrolled in a trial of exercise and testosterone therapy. The Brief Resilience Scale (BRS) measured baseline resilience and was categorized as low (BRS < 4) or high (BRS ≥ 4). Sociodemographic (eg, education), medical, and neuropsychological factors (eg, cognition by Short Blessed Test, mental health by a Global Mental Health Score (PROMIS-GMH), and depressive symptoms by Geriatric Depression Score (GDS)) were considered as independent variables. Individual factors were evaluated for their association with resilience using bivariate regression, and those having a significance level of p ≤ .10 were entered into age-adjusted multivariate logistic regression models.
A total of 57 women (44%) reported high resilience. Neither education nor cognition was significantly associated with resilience. Lower GDS and better PROMIS-GMH scores were associated with high resilience in adjusted models. For every one-point worsening in GDS, the adjusted odds ratio (AOR) for high versus low resilience was 0.76 (95% CI, 0.61,0.93). In a model with GDS, PROMIS-GMH, and age, positive mental health remained significantly associated with higher resilience (AOR 1.34, 95% CI, 1.14,1.58).
In older women after hip fracture, fewer depressive symptoms and better mental health were associated with higher psychological resilience. Addressing overall mental health when recovering from a hip fracture could contribute to increasing psychological resilience thereby maximizing recovery potential.
心理弹性高与髋部骨折康复的老年人功能改善相关。本研究的目的是确定髋部骨折后老年女性心理弹性增加的相关因素。
总共129名年龄≥65岁且近期接受手术修复髋部骨折的女性参加了一项运动和睾酮治疗试验。使用简短心理弹性量表（BRS）测量基线心理弹性，并分为低（BRS<4）或高（BRS≥4）。社会人口统计学（如教育程度）、医学和神经心理学因素（如通过简易精神状态检查表评估认知、通过全球心理健康评分（PROMIS-GMH）评估心理健康、通过老年抑郁量表（GDS）评估抑郁症状）被视为自变量。使用双变量回归评估个体因素与心理弹性的关联，将显著性水平p≤0.10的因素纳入年龄调整的多变量逻辑回归模型。
共有57名女性（44%）报告心理弹性高。教育程度和认知与心理弹性均无显著关联。在调整模型中，较低的GDS得分和较好的PROMIS-GMH得分与高心理弹性相关。GDS每恶化1分，高心理弹性与低心理弹性的调整优势比（AOR）为0.76（95%CI，0.61，0.93）。在包含GDS、PROMIS-GMH和年龄的模型中，积极的心理健康仍然与较高的心理弹性显著相关（AOR 1.34，95%CI，1.14，1.58）。
在髋部骨折后的老年女性中，较少的抑郁症状和较好的心理健康与较高的心理弹性相关。髋部骨折康复时关注整体心理健康可能有助于提高心理弹性，从而最大限度地发挥康复潜力。
