Psychological Resilience to Lifetime Trauma and Risk for Cardiometabolic Disease and Mortality in Older Adults: A Longitudinal Cohort Study

Objective: Trauma exposure is associated with risk for cardiometabolic disease and mortality, in part through negative psychological sequelae. In contrast, psychological resilience, showing positive psychological health despite experiencing trauma, may offset some of this risk. We examined longitudinal associations of psychological resilience to lifetime trauma and cardiometabolic outcomes and mortality in a large sample of older adults.

Methods: Using data from 6596 US Health and Retirement Study participants who had experienced lifetime trauma (mean age 64), we defined manifested psychological resilience based on trauma burden and psychological health (composite of low distress and high psychological well-being) through 2012. New onset cardiometabolic disease (heart problems, stroke, diabetes) and mortality were assessed across eight years of follow-up (through 2020). Repeated measures regressions determined associations between psychological resilience and outcomes over follow-up, adjusting for sociodemographic factors and prior disease.

Results: Higher levels of manifested psychological resilience were associated with lower risk for developing any cardiometabolic outcomes (relative risk for one SD higher resilience score, RR = 0.91, 95%CI 0.88-0.94) and for all-cause mortality (RR = 0.73, 95%CI 0.63, 0.86), adjusting for sociodemographic confounders. When examining individual diseases, resilience was significantly associated with lower risk for certain heart problems (i.e., congestive heart failure) and diabetes. Associations generally held when additionally adjusting for adult psychosocial and biobehavioral factors that could be potential pathway variables.

Conclusion: Psychological resilience to lifetime trauma may be linked to better cardiometabolic health even later in life. Promoting recovery and psychological resilience to trauma may be a target for more favorable health and longevity.