Burrows Brett T, Olsen Maren K, Berkowitz Theodore S Z, Smith Battista, Whitson Heather E, DePasquale Nicole, Wang Virginia, Maciejewski Matthew L, Crowley Steven D, Bowling C Barrett
Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Health Care System (VAHCS), Durham, North Carolina, USA.
Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina, USA.
J Am Geriatr Soc. 2025 Jun;73(6):1877-1883. doi: 10.1111/jgs.19422. Epub 2025 Mar 13.
Psychological resilience has been characterized as the ability to recover from stressful life events. Not well studied is whether self-reported measures of psychological resilience are associated with physical function recovery. Therefore, we examined the association of self-reported psychological resilience with longitudinal physical function before and after an acute care encounter.
This analysis includes a national cohort (n = 272) of Veterans (≥ 70 years) with advanced chronic kidney disease who had physical function measures before and after an acute care encounter (emergency department visit, hospitalization). At enrollment, self-reported psychological resilience was assessed via the Brief Resilience Scale (BRS) (range 1-5, higher scores indicate greater resilience). BRS scores were categorized as Low, Moderate, and High psychological resilience. Physical function was ascertained at enrollment, approximately every 8 weeks, and immediately following an acute care encounter using the Life-Space Assessment (LSA) (range 0-120, higher scores reflect greater mobility). Linear models for longitudinal data were used to estimate differences in physical function over time by psychological resilience group.
Physical function levels differed by resilience group both before and after the acute care encounter. Although all resilience groups had the lowest LSA scores immediately following the acute care encounter, differences were seen by resilience group (Low: 38.5, Moderate: 44.9, High: 52.5). Differences remained during recovery at the first post-encounter follow-up (Low: 43.6, Moderate: 49.0, High: 57.5). At the second post-encounter follow-up, only the High resilience group displayed a continued increase in physical function (estimated mean difference of 11.6 (95% CI 1.5, 21.8, p = 0.02) vs. Moderate and 17.7 (95% CI 4.2, 31.3, p = 0.01) vs. Low).
Self-reported psychological resilience was associated with physical function levels before and after an acute care encounter. The BRS may be a useful tool to identify older adults who are less likely to recover after an acute health event.
心理韧性被定义为从压力性生活事件中恢复的能力。自我报告的心理韧性测量指标是否与身体功能恢复相关，目前尚未得到充分研究。因此，我们研究了自我报告的心理韧性与急性护理前后纵向身体功能之间的关联。
本分析纳入了一个全国性队列（n = 272），其中≥70岁的患有晚期慢性肾病的退伍军人在急性护理（急诊科就诊、住院）前后进行了身体功能测量。在入组时，通过简短韧性量表（BRS）评估自我报告的心理韧性（范围为1 - 5，分数越高表明韧性越强）。BRS分数被分为低、中、高心理韧性类别。在入组时、大约每8周以及急性护理后立即使用生活空间评估（LSA）确定身体功能（范围为0 - 120，分数越高反映活动能力越强）。使用纵向数据的线性模型来估计心理韧性组随时间的身体功能差异。
在急性护理前后，身体功能水平因韧性组而异。尽管所有韧性组在急性护理后立即LSA分数最低，但韧性组之间存在差异（低：38.5，中：44.9，高：52.5）。在首次护理后随访恢复期间差异仍然存在（低：43.6，中：49.0，高：57.5）。在第二次护理后随访时，只有高韧性组的身体功能持续增加（估计平均差异为11.6（95%CI 1.5, 21.8, p = 0.02）对比中韧性组，17.7（95%CI 4.2, 31.3, p = 0.01）对比低韧性组）。
自我报告的心理韧性与急性护理前后的身体功能水平相关。BRS可能是一种有用的工具，可用于识别在急性健康事件后恢复可能性较小的老年人。
