Resilience, the subject of a large-scale study published recently in The Gerontologist, reminds me of what a Supreme Court justice once said of pornography: It’s hard to define, but we know it when we see it.
We’ve all noticed resilience’s effects, haven’t we? Most older people cope with several chronic diseases and have encountered losses and challenges. Some seem to withdraw into isolation and inactivity even when they remain relatively strong.
Others respond more like the late Evelyn Nade, whom I met in a New Jersey nursing home a few years ago. She was 82 then, a wheelchair user who couldn’t rise from her bed without two aides using a mechanical hoist — yet she was the sunniest person in the place, the president of the residents’ council, the founder of a Red Hat Society chapter and a formidable poker player.
Age, health and finances can’t fully explain such disparities, so social scientists are constantly exploring other factors that might play a role.
When I spoke with the new study’s lead author, Lydia Manning, a gerontologist at Concordia University Chicago, she took a stab at a simple definition of resilience: “How people manage adversity and hardship over the life course.” Often, she said, they talk about learning this trait, this sense of themselves as people who can negotiate obstacles, from tough experiences earlier in life.
Scientists have been writing and thinking about resilience for several decades. Now, in Dr. Manning’s study of 10,753 people (average age: almost 69) drawn from three waves of the national Health and Retirement Study, “we’re starting to measure it,” Dr. Manning said — “as squishy and fuzzy a concept as it is.”
To do that, the team devised and validated a simplified scale of 12 items, based on how strongly subjects agreed or disagreed with statements like: “When I really want to do something, I usually find a way to succeed at it,” and “I have a sense of direction and purpose in life.” Also included were statements like, “If something can go wrong for me, it will,” and “There is really no way I can solve the problems I have.”
Over two years, 11 percent of this sample developed a new chronic condition: heart or lung disease, stroke, psychiatric problems, cancer.
These can be devastating. Yet the higher people scored on the resilience scale, the less likely this new obstacle was to disable them.
The researchers looked at their subjects’ subsequent ability to perform “activities of daily living,” like bathing and dressing, and to handle “instrumental activities of daily living” like using a phone and making meals.
Dr. Manning and her colleagues tried to account for the participants’ actual health, including depression, and for sociodemographic differences. The researchers found that when a new disease struck, the least resilient had on average nearly triple the amount of activities of daily living disabilities, compared to the most resilient.
Resilience provided what researchers called a “moderating effect.” The extent of disability among this relatively young population was already low: Among those facing a new illness, the least resilient subsequently experienced on average only one A.D.L. disability. But the most resilient were on average barely disabled at all by a new illness.
“You throw something at them, something bad — a new chronic condition is really hard — and we see this bounce-back pretty rapidly,” said the co-author Dawn Carr, a gerontologist at the Stanford Center on Longevity. “They’re able to maintain their function.”
How this works is a question this study can’t answer. But Dr. Manning points out that people often describe resilience as acquired, during “moments of adversity.”
So perhaps other people can acquire it, too, even late in life. “What strategies would help people bolster their resilience?” she said, envisioning “resilience interventions” in the future. “I believe that unlike some concepts — where you either have it or you don’t, you’re resilient or you’re vulnerable — everybody has the capacity for resilience.”
Confession: I’m neither a religious nor a “spiritual” person, and much of the positive-attitude talk we constantly hear strikes me as malarkey. Sometimes, what doesn’t kill you makes you weaker. And yet. …
I’ve reported here on evidence that a sense of purpose correlates with lower rates of Alzheimer’s disease and that volunteering in schools is linked to improved cognitive function.
I’ve come across a couple of recent studies on the impact of religiosity. Even “nonorganizational forms” appear to protect against depression or help people recover from it, and religious attendance is associated with lower levels of certain physiological problems.
Self-efficacy, mastery, gratitude — they’re amorphous concepts, but researchers are finding that they can have real-world effects. As we all wait to learn more, it’s clear that a healthy old age, however defined, involves more than excellent blood pressure.
Something else is going on. “It is slippery stuff,” Dr. Manning acknowledged. “I find it fascinating.”