engleski

Resilience in very old age: evidence from residents of long-term care institutions

Background: Evidence from studies conducted in community dwelling older adults indicate the beneficial effect of resilience on health and longevity but this relationship has not been adequately examined in the institutional settings. Resilience connotes the ability to adapt positively to adversity and can be well preserved at the very end of the lifespan. Exploring the resilience in institutionalized elderly, especially in those of very advanced age, can help to increase our understanding of how institutions can facilitate successful aging. The purpose of this study was to investigate the resilience among the oldest-old residents of long-term care institutions and to determine its association with age, sociodemographic factors and health status. Methods: Data were collected from the interviews with 330 persons aged 85-101 years in 13 retirement homes of Zagreb (Croatia) using cross-sectional design. The instruments used in the study included resilience scale, questions about demographic and socioeconomic characteristics (age, sex, marital status, education, pension status) and health status (chronic conditions, Activities-of-Daily- Living, Mini-Mental-State-Examination, Mini- Nutritional-Assessment, stress, parental longevity). Resilience was analyzed as a dichotomous variable (higher versus lower) using logistic regression. Independent variables in the models comprised all the above mentioned sociodemographic and health characteristics. Results: A total of 42% of subjects had higher resilience level. Age showed no association with the resilience without adjusting for any confounders. After controlling for sociodemographic and health characteristics, nonagenarians were in fact more resilient than the octogenarians (odds ratio - OR:1.91 ; 95% confidence interval – CI:1.02-3.55). There was no association with sex, education nor pension status but still having a spouse had strong positive effect (OR:3.48 ; CI:1.33-9.07). Among potential health confounders, only the good nutritional status showed association with higher resilience (OR:2.20 ; CI:1.26-3.83). Additionally, coping with stressful life events had a significant positive effect on resilience (OR:2.27 ; CI:1.05-4.91). Conclusion/Implications: The findings indicate that resilience does not decline in very advanced age. The study has quantified the role of sociodemographic and health factors associated with resilience among the oldest-old Croatian institutionalized persons. Policies and programs to promote resilience would have long-term and positive effects on the well- being for senior persons and their families.

resilience ; health status ; nutritional status ; oldest-old ; institutionalized elderly

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