First exploration of mental health resilience and loneliness of older people with cognitive impairment in Wales

Scientists have identified a group of people who appear to be remarkably resilient in that they do not report experiencing mental health difficulties despite dementia or cognitive impairment.

A recent study, published in the International Journal of Geriatric Psychiatry, found that these individuals with mental health resilience are also less likely to experience loneliness.

As a result of their findings, the authors call for services and opportunities for people living at home with dementia, which support their self-esteem and reinforce social connections, and enable them to continue to function to the best of their ability despite their condition, and be supported to make a useful contribution.

These aspects all support resilience and prevent loneliness.

The investigation involved experts from the Universities of Bangor, Auckland and Amsterdam. It used information provided by 579 people over the age of 65 with cognitive impairment living in Wales, drawn from over 3500 people who took part in two waves of data collection two years apart as part of the Cognitive Function and Aging Study Wales (CFAS Wales).

Almost one-third of older people living with cognitive impairment experienced moderate to severe loneliness at both time-points according to the analysis, funded by the Economic and Social Research Council. Just under a quarter of them demonstrated mental health resilience, or the absence of depression and anxiety and high wellbeing.

The scientists were interested in how individuals develop mental health resilience, and examined social engagement and connections, psychological resources and aspects of a healthy lifestyle, such as diet, physical activity and alcohol consumption.

They found that people who had higher self-esteem, greater social connections such as support from family and friends, and didn't report any memory problems also had greater mental health resilience. They also found that men were more likely to experience mental health resilience than women. Many of those people with mental health resilience were found to be experiencing less loneliness two years later.

For people with more severe difficulties with memory and thinking, self-esteem and social connections were especially important for experiencing less loneliness.

Gill Windle, Professor of Aging and Dementia Research at Bangor University's School of Health Sciences said, "Resilience in younger populations has been the subject of numerous studies, but in comparison, the study of resilience in later life has not received the same attention. To our knowledge, this is the first exploration of mental health resilience in this population, and so is an important first step towards advancing new knowledge. We do not in any way seek to downplay the devastating impact dementia may have for some people, but show there is diversity in the experience, and that some people are doing okay."

Around the world, many societies are moving towards establishing 'age friendly' and 'dementia supportive' communities.

Proessor Gill Windle said, "This is important, as individuals may be unable to become resilient if the community does not facilitate services and opportunities, and embed the principles of national and international dementia policies for living as well as possible. However the COVID-19 pandemic has had a particularly damaging impact on people living with dementia and their carers, intensified by the withdrawal of services that are often already limited in provision, but were seen by many as a lifeline."

The authors say that it is imperative that services are restored—in adapted form where necessary- and that steps are taken to combat loneliness in people with dementia and those at risk.