Academic journal article Annual Review of Gerontology & Geriatrics

Resilience, Stress, and Mood Disorders in Old Age

Academic journal article Annual Review of Gerontology & Geriatrics

Resilience, Stress, and Mood Disorders in Old Age

Article excerpt

ABSTRACT

This chapter summarizes the literature on resilience and vulnerability factors related to late-life mood and anxiety disorders. The author identifies key concepts and definitions of resilience and reviews psychosocial and biological factors contributing to resilience that are universal across age groups, as well as factors that are unique to aging. The author reviews currently existing and potentially useful intervention approaches to promote resilience and well-being as a prevention strategy for late-life mood disorders. Views on future direction in resilience research and interventions targeting resilience are further offered.

INTRODUCTION

Global population aging presents various challenges worldwide. Human life expectancy has increased steadily for the last 200 years. The continuing increase in life expectancy in the last 50 years has been almost entirely attributable to a decline in late-life mortality and secondary to medical advances and improved socioeconomic conditions. However, quality of life in later years does not necessarily follow increased longevity. Getting older can be stressful because of multiple losses such as financial, psychosocial, personal, a decline in health, independence, and cognitive and functional abilities. According to the cybernetic theory of stress, coping, and well-being, stress is a negatively perceived discrepancy between an individuals perceived and desired states important for his or her functioning (Edwards & Cooper, 1988) that is particularly relevant for aging adults. As George E. Vaillant (2002) pointed out in his book Aging Well, "The major factors involved in negative personality change at midlife are the same factors that caused negative aging at 70: bad habits, bad marriage, maladaptive defenses, and disease."

Resilience to stress is one of the factors that had numerous meanings in prior research, but it generally refers to a pattern of functioning that is indicative of a positive adaptation in the context of adversity. People who are resilient display a greater capacity to quickly regain equilibrium physiologically and psychologically following stressful events, and are able to sustain it in the face of adversity. In a broader sense, resilience refers to the ability to maintain biological and psychological homeostasis under stress. However, components of resilience may vary with context, time, age, gender, and cultural origin. The question remains whether a certain level of adversity or a threshold is required before resilience becomes a meaningful concept, or resilience can be viewed as a dynamic process of adaptation to everyday challenges of growing old. The latter appears to be more useful in explaining longevity and successful aging.

As noted by Masten (2001), resilience occurs in the context of ordinary lives. Some of the resilience constructs have been tested in centenarians who successfully survived into a very old age despite many adversities (e.g., they outlive their families, have low income and multiple chronic illnesses). Three aspects of resilience have been linked to longevity, quality of life, and optimal functioning and well-being in these survivors: "robust personality" with low levels of neuroticism and high conscientiousness and extraversion, cognitive reserve, and social and perceived economic resources. On the other hand, depression in late-life is associated with increased mortality, morbidity, and poor quality of life (Lavretsky & Kumar, 2002; Lavretsky & Zheng et al.) The search is on for new interventions to boost resilience in aging adults that can prevent or reverse negative impact of depression on quality of life. In this chapter, we will review the literature pertaining to such efforts in defining resilience and positive emotions that are crucial in protecting against chronic stress and late-life mood and anxiety disorders.

RESILIENCE TO ADVERSITY IN AGING

All humans are destined to experience adversities throughout their lives that are likely to impact their health and quality of life. …

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