Resilience in Parkinson’s disease: An empirical examination of age-related components of the construct

摘要

Although Parkinson’s disease (PD) is commonly characterized by motor symptoms and physical limitations, there is growing recognition of nonmotor and mood symptoms associated with the disease as well. There has been limited research exploring how individual coping might affect the relationships between PD symptoms and mental health outcomes. The resilience construct was originally developed within the child literature, and it is often used in conceptualizing how people have adaptive or positive outcomes when facing adversity. Current resilience measures may not adequately assess the construct within an older population, however, given the unique emotion regulation and coping skills seen in late life. This survey study of 139 community-dwelling adults with PD (M age = 64.25 years, SD = 10.12, range 34-89 years) investigated whether resilience moderated the relationship between PD-related factors (nonmotor symptoms, functional impairment, and disease symptom-related QOL) and mental health outcomes (depression, apathy, satisfaction with and adjustment-quality of life). Further analyses explored whether hypothesized age-related resilience components (optimism, goal-flexibility, and meaning-making ability), accounted for unique variance above and beyond a standard resilience measure (Resilience Scale for Adults). Results indicated that disease symptom-related QOL predicted depression and adjustment-related QOL, while functional impairment predicted apathy, life satisfaction, and adjustment related QOL. Participants overall reported moderate to high resilience; resilience was a significant predictor of all mental health/QOL outcome measures, and those with comparatively lower self-reported resilience had worse disease symptoms. Resilience did not moderate the relationship between disease symptoms and mental health/QOL. Meaning-making ability and goal-flexibility accounted for unique variance above and beyond the standard resilience measure for several outcome variables. Age was a significant moderator, such that the protective value of meaning-making ability and optimism on depression were greater for younger compared to older participants. This study highlighted the presence of moderate to high resilience in PD patients, however those with comparatively lower resilience had poorer outcomes. Other coping variables appear to be important contributors to mental health/QOL beyond a standard resilience measure. Patient age also affected several outcomes, emphasizing the importance of further integration of developmental literature into our understanding of resilience in chronic disease management.