Abstract
BACKGROUND: Psychological resilience has been characterized as the ability to recover from stressful life events. Not well studied is whether self-reported measures of psychological resilience are associated with physical function recovery. Therefore, we examined the association of self-reported psychological resilience with longitudinal physical function before and after an acute care encounter. METHODS: This analysis includes a national cohort (n = 272) of Veterans (≥ 70 years) with advanced chronic kidney disease who had physical function measures before and after an acute care encounter (emergency department visit, hospitalization). At enrollment, self-reported psychological resilience was assessed via the Brief Resilience Scale (BRS) (range 1-5, higher scores indicate greater resilience). BRS scores were categorized as Low, Moderate, and High psychological resilience. Physical function was ascertained at enrollment, approximately every 8 weeks, and immediately following an acute care encounter using the Life-Space Assessment (LSA) (range 0-120, higher scores reflect greater mobility). Linear models for longitudinal data were used to estimate differences in physical function over time by psychological resilience group. RESULTS: Physical function levels differed by resilience group both before and after the acute care encounter. Although all resilience groups had the lowest LSA scores immediately following the acute care encounter, differences were seen by resilience group (Low: 38.5, Moderate: 44.9, High: 52.5). Differences remained during recovery at the first post-encounter follow-up (Low: 43.6, Moderate: 49.0, High: 57.5). At the second post-encounter follow-up, only the High resilience group displayed a continued increase in physical function (estimated mean difference of 11.6 (95% CI 1.5, 21.8, p = 0.02) vs. Moderate and 17.7 (95% CI 4.2, 31.3, p = 0.01) vs. Low). CONCLUSION: Self-reported psychological resilience was associated with physical function levels before and after an acute care encounter. The BRS may be a useful tool to identify older adults who are less likely to recover after an acute health event.