The Medical-Surgical Journal · Jun 2026
Independent predictors of resilience in older adults: insights from a prospective clinical study
By Grigoraș G
Aims: To evaluate the four types of resilience (physical, mental, emotional, and social) and their associations with functional capacity, physical performance, nutritional and cognitive status, muscle strength, and depressive symptoms in older adults. Materials and methods: This prospective study included 110 patients aged ≥ 50 years admitted to Dr. C.I. Parhon Clinical Hospital, Iași, with acute conditions or acute exacerbations of chronic diseases who underwent comprehensive geriatric assessment and were evaluated with the Physical Resilience Scale. Data were analyzed using nonparametric tests, Spearman correlations, and univariate/multivariate generalized linear models; significance was set at p<0.05. Results: Median resilience was 10 (IQR 8–13). Resilience showed significant positive correlations with ADL (R=0.218), IADL (R=0.397), SPPB (R=0.458), MNA (R=0.377), MMSE (R=0.322), and upper-limb muscle strength (R≈0.33). Negative correlations were observed with GDS (R=-0.676), Fried phenotype (R=-0.462), and fall risk (R=-0.331). Multivariable analysis identified IADL (IRR=1.032, p=0.043) and GDS (IRR=0.947, p<0.001) as independent predictors of resilience. Resilience did not differ according to heart failure, urinary tract infection, or osteoarticular disease, but was significantly lower in patients with reduced muscle strength. Conclusions: Resilience in older adults is a multidimensional construct closely associated with functional independence and mental health. IADL and depressive symptoms are independent determinants of resilience, underscoring the importance of maintaining autonomy and addressing depression. Multidomain interventions targeting these factors may enhance resilience and reduce vulnerability to adverse outcomes in aging populations. Longitudinal studies are warranted to clarify causal relationships and evaluate the efficacy of resilience-promoting strategies.