The ability to cope with adversity and adapt well to challenging life circumstances and events in old age is associated with a lower risk of death, a study suggests.
The large-scale nationally representative study was published in the journal .
The results underscore the importance of efforts to strengthen mental resilience, the researchers conclude.
The ability to cope with adversity lowers the risk of death
Available evidence suggests that mental resilience is a dynamic and active process influenced by various factors, including sex, hormones and genes that regulate the body’s response to stress. The ability is thought to evolve and vary with different periods of life, the researchers say.
In old age, coping skills can help offset the negative impact of chronic conditions and subsequent disabilities. While the ability to physically recover from illness and trauma is known to be associated with slower aging and a lower risk of death, it’s unclear whether mental resilience might have similar effects, the researchers explain.
To explore this, scientists analyzed data from the US Health and Retirement Study (HRS), a long-term nationally representative study of US adults aged 50 and over. This study began in 1992 and includes information on the economic status, health, and marital and family status of the participants, who are monitored every two years.
How was the study conducted?
The researchers used two waves (2006–08) of HRS data, when questions about , were first collected, and included a total of 10,569 participants with complete data in the final analysis. The average age of the participants was 66 years, and 59% of them were women.
Mental resilience was assessed using a validated scale that included qualities such as perseverance, calmness, a sense of purpose, self-reliance, and the recognition that certain experiences must be lived alone. The mean score of the entire sample was 9.18 (on a scale of 0 to 12), .
Participants were followed until death or the end of May 2021, whichever occurred first. Over a median follow-up of 12 years, 3,489 people died.
How much does the risk of death decrease?
An almost linear association emerged between the mental resilience score and: the higher the score, the lower the risk of death, and this association was stronger in women than in men.
Resilience scores were divided into quartiles (25%) and related to 10-year survival probabilities. These were 61% for those in the first (lowest) quartile, rising to 72% and 79% for the middle quartiles and 84% for those in the top (highest) quartile.
Survival analysis showed that those in the top quartile were 53% less likely to die in the next 10 years than those in the bottom quartile.
This association remained statistically significant after adjustment for marital status, sex, race, and weight (BMI), but decreased to 46% after poor health status (diabetes, cancer, and cardiovascular disease) was taken into account ) and to 38% after adjusting for an unhealthy lifestyle.
Overall, the risk of death was 20% lower (second quartile), 27% lower (third quartile), and 38% lower (fourth quartile) in those with higher mental resilience scores, compared to those with lower scores (first quartile), once confounding factors were taken into account.
How can discoveries be used to help people?
This is an observational study, and as such, no firm conclusions about causality can be drawn. The researchers acknowledge that the potential influence of genetic and hormonal factors and childhood adversities were not taken into account. The analysis was also based on baseline data, ignoring possible influential changes during the monitoring period.
“Various factors, including but not limited to meaning in life, positive emotions, self-rated health, and satisfaction with social support, have been identified as potential influences on psychological resilience,” the researchers explain.
“The triggering of these positive emotions may enhance the protective effects of psychological resilience and mitigate the negative impact of accumulated adversities on mental health in adults,” they add.
“The results highlight the potential effectiveness of interventions designed to promote psychological resilience to reduce mortality risks,” the scientists conclude.
