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Multimorbidity Resilience: Conceptual, Theoretical, and Measurement Developments

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Resilience and Aging

Part of the book series: Risk, Systems and Decisions ((RSD))

Abstract

This chapter describes the development and application of a theoretical model of multimorbidity resilience, and a measure-multimorbidity resilience index specifically aimed for use in population health surveys. The Lifecourse Model of Multimorbidity Resilience (LMMR) links resources embedded in multi-level domains and elaborates key processes that occur during disruption and reintegration along a life trajectory. It furthers our understanding of resilience processes underlying the outcomes of wellness, recovery, and growth/development among older persons facing multimorbidity. In addition, a multimorbidity resilience index comprising functional, social, and psychological domains capturing both adversity and adaptation is described. The results of criterion validation of the index based on health care utilization and health status outcomes is presented, and offers support for this measure. Further confirmatory research is needed for both the LMMR and the multimorbidity resilience index using other known population health data sets. This relevance of multimorbidity resilience has been increased during the COVID-19 pandemic and beyond. Research is also warranted using different populations and sub-populations as well as clinical settings.

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References

  • Agborsangaya, C. B., Lau, D., Lahtinen, M., Cooke, T., & Johnson, J. (2013). Health-related quality of life and healthcare utilization in multimorbidity: Results of a cross-sectional survey. Quality of Life Research, 22, 791–799. https://doi.org/10.1007/s11136-012-0214-7.

    Article  Google Scholar 

  • Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health Promotion International, 11(1), 11–18.

    Article  Google Scholar 

  • Baltes, M., & Carstenson, L. (1996). The process of successful aging. Ageing and Society, 16, 397–422.

    Article  Google Scholar 

  • Boerner, K., & Jopp, D. (2007). Improvement/maintenance and reorientation as central features of coping with major lifestyle change and loss: Contributions of three lifespan theories. Human Development, 50, 171–195.

    Article  Google Scholar 

  • Clark, P., Burbank, P., Greene, G., Owens, N., & Riebe, D. (2011). What do we know about resilience in older adults? An exploration of some facts, factors, and facets. In B. Resnick, L. Gwyther, & K. Roberto (Eds.), Resilience in aging: Concepts, research and outcomes (pp. 1–14). New York: Springer.

    Google Scholar 

  • Connelly, E., Allen, C., Hatfield, K., Palma-Oliveira, J., Woods, D., & Linkov, I. (2017). Features of resilience. Environmental Systems and Decisions, 37(1), 46–50.

    Article  Google Scholar 

  • Connor, K., & Davidson, J. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 76–82.

    Article  Google Scholar 

  • Cosco, T., Stephan, B., & Brayne, C. (2015). Validation of an a priori, index model of successful aging in a population-based cohort study: The successful aging index. International Psychogeriatrics, 27(12), 1971–1977. https://doi.org/10.1017/S1041610215000708.

    Article  Google Scholar 

  • Cosco, T., Howse, K., & Brayne, C. (2017a). Healthy ageing, resilience and wellbeing. Epidemiology and Psychiatric Sciences, 26(6), 579–583. https://doi.org/10.1017/S2045796017000324.

    Article  Google Scholar 

  • Cosco, T., Kaushal, A., Hardy, R., Richards, M., Kuh, D., & Stafford, M. (2017b). Operationalising resilience in longitudinal studies: A systematic review of methodological approaches. Journal of Epidemiology and Community Health, 77(1), 98–104.

    Article  Google Scholar 

  • Cosco, T. D., Wister, A., Brayne, C., & Howse, K. (2018). Psychosocial aspects of successful ageing and resilience: Critique, integration and implications. Estudios de Psicología, 1–19. https://doi.org/10.1080/02109395.

  • Dannefer, D., et al. (2009). Theorizing the life course: New twists in the paths. In V. Bengtson, D. Gans, N. Putney, & M. Silverstein (Eds.), Handbook of theories of aging (pp. 389–412). New York: Springer.

    Google Scholar 

  • Dekhtyar, S., Vetrano, D., Marengoni, A., Wang, H., Pan, K., Fratiglioni, L., & Calderón-Larrañaga, A. (2019). Association between speed of multimorbidity accumulation in old age and life experiences: A cohort study. American Journal of Epidemiology, 188(9), 1627–1636. https://doi.org/10.1093/aje/kwz101.

    Article  Google Scholar 

  • Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49(1), 71–75. https://doi.org/10.1207/s15327752jpa4901_13.

    Article  Google Scholar 

  • Elder, G., & Johnson, M. (2003). The life course and aging: Challenges, lessons and new directions. In R. Settersten (Ed.), Invitation to the life course: Toward new understandings of later life (pp. 49–81). Amityville: Baywood.

    Google Scholar 

  • Emlet, C., Tozay, S., & Raveis, V. (2011). “I’m not going to die from the AIDS”: Resilience in aging with the HIV disease. The Gerontologist, 51(1), 101–111.

    Article  Google Scholar 

  • Ezeamama, A., Elkins, J., Simpson, C., Smith, S., Allegra, J., & Miles, T. (2016). Indicators of resilience and healthcare outcomes: Findings from the 2010 health and retirement survey. Quality of Life Research, 25, 1007–1015. https://doi.org/10.1007/s11136-015-1144-y.

    Article  Google Scholar 

  • Fillenbaum, G. G., & Smyer, M. A. (1981). The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. Journal of Gerontology, 36(4), 428–434. https://doi.org/10.1093/geronj/36.4.428.

    Article  Google Scholar 

  • Galenkamp, H., Braam, A., Huisman, M., & Deeg, D. (2011). Somatic multimorbidity and self-rated health in the older population. Journal of Gerontology, 66B(3), 380–386. https://doi.org/10.1093/geronb/gbr032.

    Article  Google Scholar 

  • Greve, W., & Staudinger, U. (2006). Resilience in later adulthood and old age: Resources and potentials for successful aging. In D. Cicchetti & D. Cohen (Eds.), Developmental psychopathology: Risk, disorder and adaptation (Vol. 3, pp. 810–830). New York: Wiley and Sons.

    Google Scholar 

  • Guralnik, J. M., Simonsick, E. M., Ferrucci, L., Glynn, R. J., Berkman, L. F., Blazer, D. G., Scherr, P. A., & Wallace, R. B. (1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49(2), 85–94. https://doi.org/10.1093/geronj/49.2.M85.

    Article  Google Scholar 

  • Hardy, S., Concato, J., & Gill, T. (2004). Resilience of community-dwelling older persons. Journal of the American Geriatrics Society, 52, 257–262.

    Article  Google Scholar 

  • Harris, P. (2008). Another wrinkle in the debate about successful aging: The undervalued concept of resilience and the lived experience of dementia. International Journal of Aging and Human Development, 67(1), 43–61.

    Article  Google Scholar 

  • Heckhausen, J., & Schluz, R. (1995). A lifespan theory of control. Psychological Review, 102(2), 284–304.

    Article  Google Scholar 

  • Heid, A., Pruchno, R., & Wilson-Gendersen, M. (2018). Illness representations of multiple chronic conditions and self-management behaviors in older adults: A pilot study. Journal of Aging and Human Development, 87(1), 90–106. https://doi.org/10.1177/0991415018771327.

  • Institute of Medicine. (2012). Living well with chronic illness: A call for public health action. Washington, DC: The National Academies Press.

    Google Scholar 

  • Islam, M., Valderas, J., Yen, L., Dawda, P., Jowsey, T., & McRae, I. S. (2014). Multimorbidity and comorbidity of chronic diseases among the senior Australians: Prevalence and patterns. PLoS One, 9(1), e83783. https://doi.org/10.1371/journal.pone.0083783.

    Article  Google Scholar 

  • Janssen, B., Van Regenmortel, T., & Abma, T. (2011). Identifying sources of strength: Resilience from the perspective of older people receiving long term community care. European Journal of Aging, 8, 145–156.

    Article  Google Scholar 

  • Jopp, D., & Rott, C. (2006). Adaptation in very old age: Exploring the role of resources, beliefs and attitudes for centenarians’ happiness. Psychology & Aging, 21(2), 266–280.

    Article  Google Scholar 

  • Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S.-L. T., Walters, E. E., & Zaslavsky, A. M. (2002). Short screening scales to monitor population differences and trends in non-specific psychological distress. Psychological Medicine, 32, 959–976. https://doi.org/10.1017/S0033291702006074.

    Article  Google Scholar 

  • Kralik, D., van Loon, A., & Visentin, K. (2006). Resilience in the chronic illness experience. Educational Action Research, 14(2), 187–201.

    Article  Google Scholar 

  • Lawton, M. (1980). Environment and aging. Belmont: Wadsworth, Inc..

    Google Scholar 

  • Leipold, B., & Greve, W. (2009). Resilience: A conceptual bridge between coping and development. European Psychologist, 14(1), 40–50.

    Article  Google Scholar 

  • Lopes da Rosa, D., Simões-Neto, J., Santos, R., Torres, B., Baptista, M., Kimura, N., & Dourado, M. (2018). Caregivers’ resilience in mild and moderate Alzheimer’s disease. Aging & Mental Health. https://doi.org/10.1080/13607863.2018.1533520.

  • Martin, C. M. (2016). What matters in “multimorbidity”? Arguably resilience and personal health experience are central to quality of life and optimizing survival. Journal of Evaluation in Clinical Practice, 24(6). https://doi.org/10.1111/jep.12644.

  • Masten, A. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), 227–238.

    Article  Google Scholar 

  • Masten, A. (2007). Resilience in developing systems: Progress and promise as the fourth wave rises. Development and Psychopathology, 19(3), 921–930.

    Article  Google Scholar 

  • McMahon, S., & Fleury, J. (2012). Wellness in older adults: A concept analysis. Nursing Forum, 47(1), 39–51.

    Article  Google Scholar 

  • Mitchell, B. A. (2003). Life course theory. In J. Ponzetti (Ed.), The international encyclopedia of marriage and family relationships (pp. 1051–1055). New York: MacMillan Reference.

    Google Scholar 

  • Mitchell, B. A. (2018). Family matters: An introduction to family sociology in Canada (3rd ed.). Toronto: Canadian Scholar’s Press.

    Google Scholar 

  • Nygren, B., Alex, L., Jonsen, E., Gustafson, Y., Norberd, A., & Lundman, B. (2005). Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old. Aging & Mental Health, 9(4), 354–362.

    Article  Google Scholar 

  • O’Rand, A. (2006). Stratification and the life course: Life course capital, life course risks, and social inequality. In R. Binstock & L. George (Eds.), Handbook of aging and the social sciences (pp. 145–162). San Diego: Academic.

    Chapter  Google Scholar 

  • O’Rand, A., & Hamil-Luker, J. (2005). Process of cumulative adversity: Childhood disadvantage and increased risk of heart attack across the life course. Journals of Gerontology: Social Sciences, 60B(special issue II), 117–124.

    Article  Google Scholar 

  • Ong, A., Bergeman, C., & Boker, S. (2009). Resilience comes of age: Defining features in later adulthood. Journal of Personality, 77(6), 1777–1804.

    Article  Google Scholar 

  • Paterson, B. (2001). The shifting perspectives model of chronic illness. Journal of Nursing Scholarship, 33(1), 21–26.

    Article  Google Scholar 

  • Pearlin, L. I., & Skaff, M. (1996). Stress and the life course: A paradigmatic alliance. The Gerontologist, 36(2), 239–247.

    Article  Google Scholar 

  • Pearlin, L. I., Mullan, J., Semple, S., & Skaff, M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30(5), 583–594.

    Article  Google Scholar 

  • Pearlin, L. I., Schieman, S., Fazio, E. M., & Meersman, S. (2005). Stress, health, and the life course: Some conceptual perspectives. Journal of Health and Social Behavior, 46(2), 205–219. https://doi.org/10.1177/002214650504600206.

    Article  Google Scholar 

  • Pruchno, R., & Carr, D. (2017). Successful aging 2.0: Resilience and beyond. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 72(2), 201–203.

    Article  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306.

    Article  Google Scholar 

  • Raina, P., Wolfson, C., Kirkland, S., Griffith, L., Oremus, M., Wister, A. V., et al. (2009). The Canadian longitudinal study of aging. Canadian Journal of Aging, 28(3), 221–229.

    Article  Google Scholar 

  • Resnick, B., Galk, E., Dorsey, S., Scheve, A., & Gutkin, S. (2011). Reliability and validity testing of the physical resilience measure. The Gerontologist, 51(5), 643–652. https://doi.org/10.1093/geront/gnr016.

    Article  Google Scholar 

  • Richardson, G. (2002). The metatheory of resilience and resiliency. Journal of Clinical Psychology, 58, 307–321.

    Article  Google Scholar 

  • Rybarczyk, B., Emery, E., Guequierre, L., Shamaskin, A., & Behel, J. (2012). Resilience and family caregiving. In B. Hayslip & G. Smith (Eds.), Annual review of gerontology and geriatrics, Volume 32, 2012, special issue: Emerging perspectives on resilience in adulthood and later life (pp. 173–188). New York: Springer.

    Google Scholar 

  • Salive, M. (2013). Multimorbidity in older adults. Epidemiologic Reviews, 35, 75–83. https://doi.org/10.1093/epirev/mxs009.

    Article  Google Scholar 

  • Searle, S., Mitnitski, A., Gahbauer, E., Gill, T., & Rockwood, K. (2008). A standard procedure for creating a frailty index. Biomedical Central Geriatrics, 8(24). https://doi.org/10.1186/1471-2318-8-24.

  • Segovia, L., Moore, J., Lhnville, S., Hoyt, R., & Hain, R. (2013). Sleep and resilience: A longitudinal 37-year follow-up study of Vietnam repatriated prisoners of war. Military Medicine, 178(2), 196.

    Article  Google Scholar 

  • Seligman, M., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5–14.

    Article  Google Scholar 

  • Sells, D., Sledge, W., Wieland, M., Walden, D., Flanagan, E., Miller, R., & Davidson, L. (2009). Cascading crises, resilience, and social support within the onset and development of multiple chronic conditions. Chronic Illness, 5, 92–102.

    Article  Google Scholar 

  • Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science & Medicine, 32(6), 705–714. https://doi.org/10.1016/0277-9536(91)90150-B.

    Article  Google Scholar 

  • Silverman, A., Molton, I., Alschuler, K., Ehde, D., & Jensen, M. (2015). Resilience predicts functional outcomes in people aging with disabilities: A longitudinal investigation. Archives of Physical Medicine and Rehabilitation, 96, 1262–1268.

    Article  Google Scholar 

  • Sinclair, V., & Wallston, K. (2004). The development and psychometric evaluation of the Brief Resilient Coping Scale. Assessment, 11(1), 94–101.

    Article  Google Scholar 

  • Stewart, D., & Yuen, T. (2011). A systematic review of resilience in the physically ill. Psychosomatics, 52(3), 199–209.

    Article  Google Scholar 

  • Stokols, D. (1992). Establishing and maintaining healthy environments: Toward a social ecology of health promotion. American Psychologist, 47(1), 6–22.

    Article  Google Scholar 

  • Tinetti, M. E., McAvay, G. J., Chang, S. S., Newman, A. B., Fitzpatrick, A. L., Fried, T. R., & Peduzzi, P. N. (2011). Contributions of multiple chronic conditions to universal health outcomes. Journal of the American Geriatric Society, 59(9), 1686–1691. https://doi.org/10.1111/j.1532-5415.2011.03573.x.

    Article  Google Scholar 

  • Trivedi, R., Bosworth, H., & Jackson, G. (2011). Resilience in chronic illness. In B. Resnick, L. Gwyther, & K. Roberto (Eds.), Resilience in aging: Concepts, research and outcomes (pp. 45–63). New York: Springer.

    Google Scholar 

  • Ungar, M. (2011). The social ecology of resilience: Addressing contextual and cultural ambiguity of a nascent construct. American Journal of Orthopsychiatry, 81(1), 1–17.

    Article  Google Scholar 

  • Wild, K., Wiles, J., & Allen, R. (2013). Resilience: Thoughts on the value of the concept for critical gerontology. Ageing & Society, 33(1), 137–158.

    Article  Google Scholar 

  • Wiles, J., Wild, K., Kerse, N., & Allen, R. (2012). Resilience from the point of view of older people: ‘There’s still life beyond the funny knee’. Social Science and Medicine, 74, 416–424.

    Article  Google Scholar 

  • Windle, G. (2011). What is resilience? A review and concept analysis. Reviews in Clinical Gerontology, 21(2), 152–169. https://doi.org/10.1017/S0959259810000420.

    Article  Google Scholar 

  • Windle, G., Woods, R., & Markland, D. (2010). Living with ill-health in old age: The role of a resilient personality. Journal of Happiness Studies, 11, 763–777.

    Article  Google Scholar 

  • Windle, G. (2012). The contribution of resilience to healthy ageing. Perspectives in Public Health, 132(4): 159–160. https://doi.org/10.1177/1757913912449572.

  • Wister, A.V. (2005). Baby boomer health dynamics: how are we aging? Toronto ON: University of Toronto Press.

    Google Scholar 

  • Wister, A. (2019). Aging as a social process: Canada and beyond (7th ed.). Don Mills: Oxford University Press.

    Google Scholar 

  • Wister, A., Kendig, H., Mitchell, B. A., Fyffe, I., & Loh, V. (2016a). Multimorbidity, health and aging in Canada and Australia: A tale of two countries. Biomedical Central Geriatrics, 16(1). https://doi.org/10.1186/s12877-016-0341-z.

  • Wister, A., Coatta, K., Schuurman, N., Lear, S., Rosin, M., & MacKey, D. (2016b). A Lifecourse model of resilience applied to aging with multimorbidity. International Journal of Aging & Human Development. https://doi.org/10.1177/0091415016641686.

  • Wister, A., et al. (2018). Development and validation of a multi-domain multimorbidity resilience index for an older population: Results from the baseline Canadian longitudinal study on aging. Biomedical Central (BMC) Geriatrics, 18, 170. https://doi.org/10.1186/s12877-018-0851-y.

    Article  Google Scholar 

  • Wister, A., Cosco, T., Mitchell, B., Menec, V., & Fyffe, I. (2019). Development and concurrent validity of a composite social isolation index for older adults using the Canadian Longitudinal Study on Aging. Canadian Journal on Aging, 38(2), 180–192. https://doi.org/10.1017/S0714980818000612.

    Article  Google Scholar 

  • Wister, A., Cosco, T., Mitchell, B., & Fyffe, I. (2020a). Health behaviors and multimorbidity resilience among older adults using the Canadian Longitudinal Study on Aging. International Psychogeriatrics. First View 1–15. https://doi.org/10.1017/S1041610219000486.

  • Wister, A., Rosenkrantz, L., Shashank, A., Walker, B., & Schuurman, N. (2020b). Multimorbidity and socioeconomic deprivation among older adults: A cross-sectional analysis in five Canadian Cities Using the CLSA. Environment and Aging. https://doi.org/10.1080/26892618.2020.1734138.

  • Zautra, A., Arewasikporn, A., & Davis, M. (2010). Resilience: Promoting well-being through recovery, sustainability, and growth. Research in Human Development, 7(3), 221–238. https://doi.org/10.1080/15427609.2010.504431.

    Article  Google Scholar 

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  1. Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada

    Andrew V. Wister

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  1. Simon Fraser University, Gerontology Research Centre, Vancouver, BC, Canada

    Andrew V. Wister

  2. Simon Fraser University, Gerontology Research Centre, Vancouver, BC, Canada

    Theodore D. Cosco

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Wister, A.V. (2020). Multimorbidity Resilience: Conceptual, Theoretical, and Measurement Developments. In: Wister, A.V., Cosco, T.D. (eds) Resilience and Aging. Risk, Systems and Decisions. Springer, Cham. https://doi.org/10.1007/978-3-030-57089-7_5

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