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

Author

Listed:
  • 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
    Mediterranea Cardiocentro, 80121 Napoli, Italy)

  • Licia Iacoviello

    (Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese, Italy
    Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy)

  • on behalf of the Moli-Sani Study Investigators

    (Moli-Sani Study Investigators are listed in the Supplementary Material File S1.)

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.

Suggested Citation

  • Anwal Ghulam & Marialaura Bonaccio & Simona Costanzo & Alessandro Gialluisi & Federica Santonastaso & Augusto Di Castelnuovo & Chiara Cerletti & Maria Benedetta Donati & Giovanni de Gaetano & Francesc, 2021. "Association of Psychological Resilience with All-Cause and Cardiovascular Mortality in a General Population in Italy: Prospective Findings from the Moli-Sani Study," IJERPH, MDPI, vol. 19(1), pages 1-12, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2021:i:1:p:222-:d:711281
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    References listed on IDEAS

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    1. Ke Shen & Yi Zeng, 2010. "The association between resilience and survival among Chinese elderly," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 23(5), pages 105-116.
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