Background
Resilience, multimorbidity and aging
Methods
Design and sample
Measurement
Multimorbidity resilience index
Functional resilience variables
Social resilience variables
Psychological resilience variables
Item | Survey Question | Responses | Value | Score Calculation |
---|---|---|---|---|
Summary Performance Score | Lowest quartile | 0 | A | |
Second lowest quartile | 3.3 | |||
Second highest quartile | 6.7 | |||
Highest quartile | 10 | |||
OARS ADL Scale | Lowest quartile | 0 | B | |
Remainder | 10 | |||
OARS Instrumental ADL Scale | Lowest quartile | 0 | C | |
Remainder | 10 | |||
Functional Resilience (FR) | Derived interval scale | (A + B + C) / 3 = FR | ||
Satisfaction with Life Scale | Lowest quartile | 0 | D | |
Second lowest quartile | 3.3 | |||
Second highest quartile | 6.7 | |||
Highest quartile | 10 | |||
Center for Epidemiologic Studies Depression Scale | Highest quartile | 0 | E | |
Second highest quartile | 3.3 | |||
Second Lowest quartile | 6.7 | |||
Lowest quartile | 10 | |||
Kessler Psychological Distress Scale | Highest quartile | 0 | F | |
Second highest quartile | 3.3 | |||
Second lowest quartile | 6.7 | |||
Lowest quartile | 10 | |||
Psychological Resilience (PR) | Derived interval scale | (D + E + F) / 3 = PR | ||
MOS Social Support Total Scale | Lowest quartile | 0 | G | |
Second lowest quartile | 3.3 | |||
Second highest quartile | 6.7 | |||
Highest quartile | 10 | |||
Loneliness | How often did you feel lonely in the past week? | All of the time (5–7 days) | 0 | H |
Occasionally (3–4 days) | 3.3 | |||
Some of the time (1–2 days) | 6.7 | |||
Rarely or never (< 1 day) | 10 | |||
Social Participation | Frequency of participation in family or friends activities out of the household | Never | 0 | I |
At least once a year | 2.5 | |||
At least once a month | 5.0 | |||
At least once a week | 7.5 | |||
At least once a day | 10 | |||
Social Resilience (SR) | Derived interval scale | (G + H + I) / 3 = SR | ||
Total Resilience (TR) | Derived interval scale | (FR + PR + SR)/3= TR |
Criterion outcome variables
Covariates
Data analyses
Results
Intercorrelations of resilience indices
Continuous Resilience Index Items | Range | Mean | Standard Deviation |
---|---|---|---|
Summary Performance Score | 0 to 12 | 7.03 | 2.87 |
OARS ADL Scale | 4 to 14 | 13.52 | .91 |
OARS Instrumental ADL Scale | 7 to 14 | 13.84 | .60 |
Satisfaction with Life Scale | 0 to 35 | 28.16 | 5.85 |
CES-D Depression Scale | 0 to 28 | 5.41 | 4.51 |
Kessler Psychological Distress Scale | 10 to 48 | 14.33 | 4.47 |
MOS Social Support Total Scale | 0 to 64 | 51.15 | 11.02 |
Ordinal Resilience Index Items | Frequency (%) | ||
Loneliness | All of the time (5–7 days) | 164 (2.4) | |
Occasionally (3–4 days) | 651 (9.6) | ||
Some of the time (1–2 days) | 1000 (14.8) | ||
Rarely or never (< 1 day) | 4956 (73.2) | ||
Social Participation | Never | 55 (.8) | |
At least once a year | 510 (7.5) | ||
At least once a month | 2558 (37.8) | ||
At least once a week | 3362 (49.6) | ||
At least once a day | 286 (4.2) | ||
Resilience Index Variables | Range | Mean | Standard Deviation |
Functional Resilience Index | 0 to 10 | 7.09 | 2.61 |
Psychological Resilience Index | 0 to 10 | 5.19 | 2.92 |
Social Resilience Index | 0 to 10 | 6.65 | 1.88 |
Total Resilience Index | .28 to 10 | 6.31 | 1.83 |
Outcome Variables | Frequency (%) | ||
Emergency Department Visitation | No | 5252 (77.6) | |
Yes | 1519 (22.4) | ||
Hospital Admission - Overnight | No | 5909 (87.3) | |
Yes | 862 (12.7) | ||
Pain | None/Mild | 4901 (72.4) | |
Moderate/Severe | 1870 (27.6) | ||
Perceived Health | Fair / Poor | 755 (11.2) | |
Good / Very Good / Excellent | 6016 (88.8) | ||
Sleep Quality | Very Dissatisfied / Dissatisfied / Neutral | 2599 (38.4) | |
Very Satisfied / Satisfied | 4172 (61.6) | ||
Continuous Independent Variables | Range | Mean | Standard Deviation |
Age | 65 to 86 | 73.16 | 5.68 |
Number of Chronic Conditions | 2 to 16 | 4.03 | 1.93 |
Categorical/Ordinal Independent Variables | Frequency (%) | ||
Gender | Female | 3830 (56.6) | |
Male | 2941 (43.4) | ||
Education | No post-secondary degree, certificate or diploma | 2081 (30.7) | |
Trade certificate or diploma | 2101 (31.0) | ||
Bachelor’s degree | 1270 (18.8) | ||
University degree or certificate above bachelor’s | 1319 (19.5) | ||
Household Income | Less than $20,000 per year | 763 (11.2) | |
$20,000 to $49,999 | 466 (6.9) | ||
$50,000 to $99,999 | 2219 (32.8) | ||
$100,000 to $149,999 | 2956 (43.7) | ||
$150,000 and over | 367 (5.4) | ||
Marital Status | Single / Widowed / Divorced / Separated | 2304 (34.0) | |
Married / Common-law | 4467 (66.0) | ||
Region | British Columbia | 1341 (19.8) | |
Prairies | 1241 (18.3) | ||
Ontario | 1532 (22.6) | ||
Quebec | 1493 (22.1) | ||
Atlantic | 1163 (17.2) |
Functional Resilience | Psychological Resilience | Social Resilience | Total Resilience | |
---|---|---|---|---|
Functional Resilience | – | – | – | .69*** |
Psychological Resilience | .28*** | – | – | .82*** |
Social Resilience | .20*** | .46*** | – | .68*** |
Logistic regression analyses of resilience indices and outcome measures
Functional Resilience | Psychological Resilience | |||||||
Unadjusted | Socio-demographics | # Chronic Conditions | Final Model | Unadjusted | Socio-demographics | # Chronic Conditions | Final Model | |
Exp(β) (C.I.) | Exp(β) (C.I.) | Exp(β) (C.I.) | β | Exp(β) (C.I.) | Exp(β) (C.I.) | Exp(β) (C.I.) | β | |
Emergency Department Visitation | .92 (.90 to .94) | .93 (.91 to .95) | .96 (.94 to .98) | −.04** | .92 (.90 to .94) | .92 (.90 to .94) | .94 (.92 to .96) | −.06*** |
Hospital Admission – Overnight | .88 (.85 to .90) | .88 (.85 to .90) | .91 (.88 to .94) | −.10*** | .91 (.89 to .93) | .92 (.89 to .94) | .94 (.91 to .96) | −.07*** |
Pain | .84 (.83 to .86) | .85 (.84 to .87) | .89 (.87 to .91) | −11*** | .84 (.82 to .86) | .86 (.84 to .87) | .88 (.86 to .90) | −.13*** |
Perceived Health | 1.31 (1.28 to 1.35) | 1.35 (1.31 to 1.39) | 1.28 (1.24 to 1.31) | .24*** | 1.39 (1.34 to 1.43) | 1.38 (1.34 to 1.43) | 1.33 (1.29 to 1.38) | .29*** |
Sleep Quality | 1.05 (1.03 to 1.07) | 1.06 (1.04 to 1.08) | 1.04 (1.02 to 1.06) | .04** | 1.24 (1.22 to 1.26) | 1.25 (1.22 to 1.27) | 1.24 (1.22 to 1.27) | .22*** |
Social Resilience | Total Resilience | |||||||
Unadjusted | Socio-demographics | Chronic Conditions | Final Model | Unadjusted | Socio-demographics | Chronic Conditions | Final Model | |
Exp(β) (C.I.) | Exp(β) (C.I.) | Exp(β) (C.I.) | β | Exp(β) (C.I.) | Exp(β) (C.I.) | Exp(β) (C.I.) | β | |
Emergency Department Visitation | .95 (.92 to .97) | .96 (.93 to .99) | .97 (.94 to 1.00) | −.03* | .86 (.84 to .89) | .87 (.84 to .90) | .90 (.87 to .94) | −.10*** |
Hospital Admission – Overnight | .92 (.89 to .96) | .95 (.91 go .99) | .97 (.93 to 1.01) | −.03* | .82 (.79 to .85) | .82 (.79 to .86) | .87 (.83 to .91) | −.15*** |
Pain | .91 (.88 to .93) | .93 (.91 to .96) | .95 (.92 to .98) | −.05** | .74 (.72 to .76) | .75 (.73 to .78) | .80 (.77 to .83) | −.23*** |
Perceived Health | 1.22 (1.18 to 1.27) | 1.21 (1.15 to 1.26) | 1.18 (1.13 to 1.23) | .16*** | 1.72 (1.65 to 1.80) | 1.82 (1.73 to 1.91) | 1.68 (1.59 to 1.77) | .52*** |
Sleep Quality | 1.14 (1.11 to 1.17) | 1.16 (1.12 to 1.19) | 1.15 (1.12 to 1.18) | .14*** | 1.29 (1.26 to 1.33) | 1.35 (1.31 to 1.39) | 1.34 (1.30 to 1.38) | .29*** |