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Measuring Resilient Aging in Different Populations of Older Adults

Dissertation Oral Defense October 15th, 2012 The University of Texas Medical Branch
by

Rafael Samper

on 28 May 2015

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Transcript of Measuring Resilient Aging in Different Populations of Older Adults

Resilient Aging
in Different Populations

Cross-National Comparisons
and Resilience
Many older adults do well
Successful
Aging
Biomedical Model
Healthy Aging
Different
perspectives
The traditional aging research paradigm is missing
important information
Resilience
Adverse
Event
Resilience
Adjustment
System
(Older Adult)
Protective Factors
"The process of effectively negotiating, adapting to, or managing significant sources of stress or trauma. Assets and resources within the individual, their life and environment facilitate this capacity for adaptation and ‘bouncing back’ in the face of adversity”.(Windle, 2011)
Developing
Developed
Migration
Mixed
Epidemiological Regime
Lower
SES
Culture
Higher
SES
Culture
Advanced Stage
Epidemiological
Transition
Measuring Resilience
Conceptual Framework
Datasets Used
http://hrsonline.isr.umich.edu/
Health and Retirement
Study (HRS)
http://www.mhasweb.org/
Mexican Health and Aging
Study (MHAS)
Similarities
Differences
Prospective Nationally Representative Longitudinal Study of adults 50 years and older
Cover health status, cognitive status, employment status, job history, family structure, transfers, housing conditions
Both include some anthropometric measures
HRS started in 1992 and is still collecting data every 2 years; MHAS started in 2001, had a follow-up interview in 2003 and is now in the field collecting new data.
HRS oversampled African Americans, Hispanics and residents in Florida; MHAS oversampled high migration states.
Weights in HRS are post-stratified to the March CPS according to birth cohort, gender and race/ethnicity; MHAS weights were stratified based on birth cohort, household composition and place of residence.
The Studies
Results of Cross-National
Comparison on Resilience

Domains and variables
Health
Health Change
Hypertension
Diabetes
Lung Disease
Stroke
Arthritis
Weight Loss
Hospitalization
Pain
Cancer
Function
ADL
Disability
Mobility
Disability
IADL
Disability
Mental
Cognitive
Score
Depressive
Symptoms
Social
No Volunteer
Work
Religion not
Important
No Friends
in
Neighborhood
No one to
Count on
Three Adverse Events
Validation
Adverse Event Prediction
Domain Correlation
Component Reliability
WHO Healthy Aging
Strategy
Supportive Environments
Health and long-term care systems
Strengthen evidence base and research
Healthy Aging over the life course
Falls prevention
Vaccination and infection prevention
Physical activity
Support to informal care-giving
Geriatric and gerontological capacity building
Priority Interventions
Change
Baseline Status
Descriptive Data
MHAS
Worse health
Pain
HRS
5/6 medical conditions
Hospitalization
Health
HRS
More ADL disability
MHAS
More IADL disability
More mobility disability
Function
MHAS
Less volunteers
HRS
Less religious
Less friends close by
Less people to count on
Social
MHAS
Lower cognitive score
HRS
More depressive symptoms
Mental
Prevalence at baseline of Components
Translating Findings to
Patient Care

Falls
Heart Attack
Covariables
Demographic Characteristics
Socioeconomic Status
Childhood Health
Health Behaviors
SRH
Timing of Event
Type of Event
Baseline Status
MHAS Sample
(n=3,606)
With Event
(n=1,275)
Without Event
(n=2,331)
HRS Sample
(n=6,567)
With Event
(n=1,729)
Without Event
(n=4,838)
Sample Size from Both Studies
Predictors of Resilience
in Both Studies
Resilience is a useful concept to understand how older adults cope with adverse events.
Resilience is highly prevalent in both developing and developed countries and should therefore become a more important focus of aging research.
Analyzing older adults with a comprehensive approach enhances our ability to understand older adult health.
Conclusions
Conceptual Model of Resilience
Supportive environments
Cross-national comparisons allow us to better understand how populations in different contexts experience distinct aging paths.
Cross-national comparisons provide useful information on how older adult health will change as developing countries move through the different stages of the epidemiological transition.
The life-course approach provides useful information to better understand mechanisms and pathways that determine health in older adults.
Changing the aging research paradigm that mainly focuses on disease, disability and mortality will help us understand positive aspects of aging, allowing us to develop interventions to promote recovery and improve quality of life among older adults.
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