Association of Psychological Resilience with All-Cause and Cardiovascular Mortality in a General Population in Italy: Prospective Findings from the Moli-Sani Study

Anwal Ghulam, Marialaura Bonaccio, Simona Costanzo, Alessandro Gialluisi, Federica Santonastaso, Augusto Di Castelnuovo, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Francesco Gianfagna, Licia Iacoviello and on behalf of the Moli-Sani Study Investigators
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Anwal Ghulam: Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy
Marialaura Bonaccio: Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy
Simona Costanzo: Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy
Alessandro Gialluisi: Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy
Federica Santonastaso: Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy
Augusto Di Castelnuovo: Mediterranea Cardiocentro, 80121 Napoli, Italy
Chiara Cerletti: Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy
Maria Benedetta Donati: Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy
Giovanni de Gaetano: Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy
Francesco Gianfagna: Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy
Licia Iacoviello: Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy
on behalf of the Moli-Sani Study Investigators: Moli-Sani Study Investigators are listed in the Supplementary Material File S1.

IJERPH, 2021, vol. 19, issue 1, 1-12

Abstract: Psychological resilience (PR) is the capacity to adapt positively in face of adversity. Its role as an independent protective factor has been acknowledged in recent years. We aimed to test the association of PR with all-cause and cardiovascular disease (CVD) mortality in a general adult population. We performed longitudinal analyses on 10,406 CVD-free individuals from the Moli-Sani cohort (follow up = 11.2 year). PR was assessed by the 25-item Connor and Davidson resilience scale. PR factors were identified through polychoric factor analysis. Associations with mortality were tested using multivariable Cox regressions. Higher levels of PR were associated with reduced all-cause mortality in a model including sex and age (HR = 0.78; 95%CI 0.62–1.00). The association decreased after inclusion of socioeconomic, clinical, and behavioral factors into the model (HR = 0.80; 95%CI 0.62–1.03). No relation was observed with cardiovascular mortality in the fully adjusted model (HR = 0.89; 95%CI 0.56–1.39). An inverse association of Factor 1 (reflecting positive acceptance of change) with all-cause mortality (HR = 0.89; 95%CI 0.82–0.98; p value = 0.01) was found. However, at a borderline non-significant way, PR predicts all-cause mortality in a general population of Italian adults. This is supported by the findings demonstrating a significant association between the PR’s domain reflecting a positive acceptance of change and all-cause mortality.

Keywords: psychological resilience; mortality; cardiovascular mortality; population study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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