Associations of Resilience, Perceived Control of Health, and Depression with Geriatric Outcomes after Surgery

Objective: To identify if depression, resilience, and perceived control of health are related to 2.5-year mortality and instrumental activities of daily living (IADL) decline among older adults after surgery Summary Background Data: The relationships of psychosocial factors with postoperative mortality and IADL decline among older adults are understudied. Methods: We identified 3778 community-dwelling older adults in the Health and Retirement Study (HRS) with Medicare claims for surgery (mean SD age: 75.4 7.8 years, 53.9% women, and 86.0% non-Hispanic White). We assessed associations of depression, resilience, and perceived control of health with 2.5-year postoperative mortality and IADL decline using cox and modified Poisson regression analyses, adjusting for sociodemographic and health variables. Results: The incidence of 2.5-year postoperative mortality was 18.5% and IADL decline was 9.4%. Depression was associated with a higher incidence and adjusted hazard 95% CI of mortality (26% vs. 16%, aHR:1.20.9, 1.5), but high resilience was associated with a lower incidence and adjusted hazard of mortality (9% vs. 21%, aHR:0.60.5, 0.8). Those with depression had higher incidence and adjusted relative risk 95% CI of IADL decline (17% vs. 7%, aRR:1.61.2, 2.2), but lower incidence and adjusted relative risk of IADL decline was identified for those with high resilience (4% vs. 11%, aRR:0.60.4, 1.0) and high perceived control of health (7% vs. 10%, aRR:0.60.4, 1.0). Conclusion: While depression confers greater risk of mortality and IADL decline, higher resilience and perceived control of health may be protective. Addressing psychosocial factors in the peri-operative period may improve outcomes among older adults.