The Influence of Life Experiences on the Development of Resilience in Older People With Co-morbid Health Problems
Open accessAbstract
Background: Co-morbidity is a major late-life challenge with poor outcomes, yet many older people are resilient. We consider an ecopsychosocial framework of resilience to investigate this disparity. This theorises that sources of resilience may be personal, social and structural. We explored older people’s responses and reactions to significant life experiences, to understand resilience development for managing later life health challenges. Methods: We applied a two-stage, cross-sectional mixed-methods design to the Cognitive Function and Ageing Studies Wales (CFAS Wales). Participants’ defined quantitatively as resilient (high level of well-being despite co-morbidity) were identified in the wave 1 dataset. A sub-sample of the resilient participants aged 65+ were randomly selected for semi-structured interviews (N=20). Qualitative thematic analyses were both inductive and deductive. Results: The analyses revealed four primary life experiences reflecting different developmental trajectories. ‘Early years as formative’ and ‘work and employment as formative’ occurred at normative developmental stages in the life-course. In contrast non-normative life events such as loss, bereavement, illness of self and others underpinned the themes of ‘adverse events and experiences’ and ‘caring experiences’. Four potential mechanisms for resilience were central to these life experiences, reflecting reactions, actions and development: ‘character and self-identity’; ‘approach to life and insight’; ‘meaningful relationships and belonging’. Conclusions: This work contributes further theoretical insights into the ecopsychosocial resilience framework. It highlights the process of interdependence between the individual and the wider environment, suggesting how the availability and accessibility of resources and human agency (protective factors), can influence, and be influenced by, the timing of significant events and experiences. In doing so, it corroborates international healthy ageing policy which recognises resilience as important for a public health response to support older people to adjust to changes and losses experienced in later life. It highlights the importance of current and future policies and services for supporting the management of adverse events earlier in the life-course, and recommends that policies and services take a ‘long view’ on population health and well-being and consider the whole life-course, in addition to specific points in the ageing process.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The ecological model of resilience has been used in contexts such as older people living in poverty in Colombia, widowhood, chronic health conditions, end-of-life care, and dementia care.
“Windle and Bennett [21] developed the ecological model of resilience (Fig 1) which was originally developed in relationship to caregiving but has subsequently been used in other contexts, for example amongst older people living in poverty in Colombia [17], widowhood [10], chronic health conditions [22], and caregiving in relationship to end of life care [23] and dementia care [15].”
From Factors impacting resilience as a result of exposure to COVID-19: The ecological resilience model (2021) · cites this paper as [22]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
Tong, A., Sainsbury, P., & Craig, J. (2007) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzm042 · Cited by 42,509 · see citing works
The satisfaction with life scale
Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985) · Journal of Personality Assessment · doi:10.1207/s15327752jpa4901_13 · Cited by 31,768 · see citing works
Hirono, N., Mori, E., Ikejiri, Y., Imamura, T., Shimomura, T., Hashimoto, M., Yamashita, H., & Ikeda, M. (1997) · PubMed · Cited by 21,010 · see citing works
Kok, J. S., Berg, I. J., & Scherder, E. J. A. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000353441 · Cited by 20,589 · see citing works
Older Adults' Reasons for Using Technology while Aging in Place
Peek, S. T. M., Luijkx, K. G., Rijnaard, M. D., Nieboer, M. E., van der Voort, C. S., Aarts, S., van Hoof, J., Vrijhoef, H. J., & Wouters, E. (2015) · Gerontology · doi:10.1159/000430949 · Cited by 19,803 · see citing works
Sensitivity and False Alarm Rate of a Fall Sensor in Long-Term Fall Detection in the Elderly
Kangas, M., Korpelainen, R., Vikman, I., Nyberg, L., & Jämsä, T. J. (2014) · Gerontology · doi:10.1159/000362720 · Cited by 19,003 · see citing works
The Construct of Resilience: A Critical Evaluation and Guidelines for Future Work
Luthar, S. S., Cicchetti, D., & Becker, B. (2000) · Child Development · doi:10.1111/1467-8624.00164 · Cited by 9,381 · see citing works
Interpretative Phenomenological Analysis: Theory, Method and Research
(2010) · QMiP Bulletin · doi:10.53841/bpsqmip.2010.1.10.44 · Cited by 8,189 · see citing works
Time, Human Agency, and Social Change: Perspectives on the Life Course
Elder, G. H. (1994) · Social Psychology Quarterly · doi:10.2307/2786971 · Cited by 2,862 · see citing works
A methodological review of resilience measurement scales
Windle, G., Bennett, K. M., & Noyes, J. (2011) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-9-8 · Cited by 2,079 · see citing works
Self-citationResilience as a dynamic concept
Rutter, M. (2012) · Development and Psychopathology · doi:10.1017/s0954579412000028 · Cited by 1,853 · see citing works
What is resilience? A review and concept analysis.
Windle, G. (2011) · Reviews in Clinical Gerontology · doi:10.1017/s0959259810000420 · Cited by 1,761 · see citing works
Self-citationPsychological resilience, positive emotions, and successful adaptation to stress in later life.
Ong, A. D., Bergeman, C. S., Bisconti, T. L., & Wallace, K. A. (2006) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.91.4.730 · Cited by 1,567 · see citing works
Aging and Cumulative Inequality: How Does Inequality Get Under the Skin?
Ferraro, K. F., & Shippee, T. P. (2009) · The Gerontologist · doi:10.1093/geront/gnp034 · Cited by 998 · see citing works
Journeys from childhood to midlife: risk, resilience, and recovery
Werner, E. Ε. (2002) · Choice Reviews Online · doi:10.5860/choice.39-3669 · Cited by 965 · see citing works
Whatever does not kill us: cumulative lifetime adversity, vulnerability, and resilience
Seery, M. D., Holman, E. A., & Silver, R. C. (2010) · Journal of Personality and Social Psychology · doi:10.1037/a0021344 · Cited by 954 · see citing works
Annual Research Review: What is resilience within the social ecology of human development?
Ungar, M. T., Ghazinour, M., & Richter, J. (2012) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12025 · Cited by 870 · see citing works
Joyce, S., Shand, F., Tighe, J., Laurent, S. J., Bryant, R. A., & Harvey, S. B. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-017858 · Cited by 864 · see citing works
Resources and resilience in the transition to adulthood: Continuity and change
Masten, A. S., Burt, K. B., Roisman, G. I., Obradović, J., Long, J. D., & Tellegen, A. (2004) · Development and Psychopathology · doi:10.1017/s0954579404040143 · Cited by 501 · see citing works
Strine, T. W., Chapman, D. P., Balluz, L. S., Moriarty, D. G., & Mokdad, A. H. (2007) · Journal of Community Health · doi:10.1007/s10900-007-9066-4 · Cited by 496 · see citing works
Leppin, A. L., Bora, P. R., Tilburt, J. C., Gionfriddo, M. R., Zeballos-Palacios, C., Dulohery, M. M., Sood, A., Erwin, P. J., Brito, J. P., Boehmer, K. R., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0111420 · Cited by 405 · see citing works
Qualitative Contributions to Resilience Research
Ungar, M. T. (2003) · Qualitative Social Work · doi:10.1177/1473325003002001123 · Cited by 275 · see citing works
Manning, L. K., Carr, D. C., & Kail, B. L. (2014) · The Gerontologist · doi:10.1093/geront/gnu068 · Cited by 198 · see citing works
Resilience: thoughts on the value of the concept for critical gerontology
Wild, K., Wiles, J. L., & Allen, R. (2011) · Ageing and Society · doi:10.1017/s0144686x11001073 · Cited by 194 · see citing works
Resilience from the point of view of older people: ‘There's still life beyond a funny knee’
Wiles, J. L., Wild, K., Kerse, N. M., & Allen, R. (2011) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.11.005 · Cited by 190 · see citing works
Uniting Resilience Research and Practice With an Inequalities Approach
Hart, A., Gagnon, E., Eryigit‐Madzwamuse, S., Cameron, J., Aranda, K., Rathbone, A., & Heaver, B. (2016) · SAGE Open · doi:10.1177/2158244016682477 · Cited by 176 · see citing works
Macedo, T., Wilheim, L., Gonçalves, R., Coutinho, E. S. F., Vilete, L. M. P., Figueira, I. L. D. V., & Ventura, P. R. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0227-6 · Cited by 166 · see citing works
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · PsycTESTS Dataset · doi:10.1037/t07757-000 · Cited by 166 · see citing works
Living Well With Medical Comorbidities: A Biopsychosocial Perspective
Friedman, E. M., & Ryff, C. D. (2012) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/gbr152 · Cited by 156 · see citing works
Cosco, T. D., Kaushal, A., Hardy, R., Richards, M., Kuh, D., & Stafford, M. (2017) · Journal of Epidemiology and Community Health · doi:10.1136/jech-2015-206980 · Cited by 155 · see citing works
Understanding adversity and resilience at older ages
Hildon, Z. J., Smith, G., Netuveli, G., & Blane, D. (2008) · Sociology of Health & Illness · doi:10.1111/j.1467-9566.2008.01087.x · Cited by 152 · see citing works
Donnellan, W. J., Bennett, K. M., & Soulsby, L. K. (2015) · Aging & Mental Health · doi:10.1080/13607863.2014.977771 · Cited by 129 · see citing works
Self-citationA Lifecourse Model of Multimorbidity Resilience
Wister, A., Coatta, K. L., Schuurman, N., Lear, S. A., Rosin, M. P., & Mackey, D. C. (2016) · The International Journal of Aging and Human Development · doi:10.1177/0091415016641686 · Cited by 115 · see citing works
Incalzi, R. A., Capparella, O., Gemma, A., Landi, F., BRUNO, E., MEO, F. D., & Carbonin, P. (1997) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.1997.00132.x · Cited by 112 · see citing works
The Relationship between Disease and Function and Perceived Health in Very Frail Elders
Mulrow, C. D., Gerety, M. B., Cornell, J. E., Lawrence, V. A., & Kanten, D. N. (1994) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1994.tb07484.x · Cited by 100 · see citing works
Health and ill-health in the older population in England and Wales
Brayne, C. (2001) · Age and Ageing · doi:10.1093/ageing/30.1.53 · Cited by 81 · see citing works
Joling, K. J., Windle, G., Dröes, R., Meiland, F. J. M., van Hout, H. P. J., Vroomen, J. L. M., van de Ven, P. M., Moniz-Cook, E. D., & Woods, B. T. (2016) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000449131 · Cited by 81 · see citing works
Self-citationLiving with Ill-Health in Older Age: The Role of a Resilient Personality
Windle, G., Woods, B. T., & Markland, D. A. (2009) · Journal of Happiness Studies · doi:10.1007/s10902-009-9172-3 · Cited by 78 · see citing works
Self-citationCaring Relationships: How to Promote Resilience in Challenging Times
Windle, G., & Bennett, K. M. (2012) · The Social Ecology of Resilience · doi:10.1007/978-1-4614-0586-3_18 · Cited by 66 · see citing works
Self-citationMaladaptive coping in adults who have experienced early parental loss and grief counseling
Høeg, B. L., Appel, C., von Heymann, A., Frederiksen, K., Johansen, C., Bøge, P., Dencker, A., Dyregrov, A., Mathiesen, B. B., & Bidstrup, P. E. (2016) · Journal of Health Psychology · doi:10.1177/1359105316638550 · Cited by 50 · see citing works
Carstensen, J. M., Andersson, D., André, M., Engström, S., Magnusson, H., & Borgqúist, L. (2012) · BMJ Open · doi:10.1136/bmjopen-2011-000809 · Cited by 49 · see citing works
Understanding healthy aging: Key components and their integration.
Ryff, C. D., & Singer, B. H. (2009) · Cited by 46 · see citing works
Psychological Response to Later Life Widowhood: Coping and the Effects of Gender
Bennett, K. M., Hughes, G. M., & Smith, P. T. (2005) · OMEGA - Journal of Death and Dying · doi:10.2190/9jpj-1fm1-37nx-2dec · Cited by 45 · see citing works
Jason, K., Carr, D. C., Washington, T. R., Hilliard, T. S., & Mingo, C. A. (2015) · The Gerontologist · doi:10.1093/geront/gnv101 · Cited by 41 · see citing works
Resilience amongst Older Colombians Living in Poverty: an Ecological Approach
Bennett, K. M., Reyes-Rodriguez, M. F., Altamar, P., & Soulsby, L. K. (2016) · Journal of Cross-Cultural Gerontology · doi:10.1007/s10823-016-9303-3 · Cited by 38 · see citing works
Self-citationCosco, T. D., Hardy, R., Howe, L. D., & Richards, M. (2018) · International Psychogeriatrics · doi:10.1017/s1041610218001795 · Cited by 38 · see citing works
Affective states of patients immediately preceding suicide
Keith-Spiegel, P. C., & Spiegel, D. E. (1967) · Journal of Psychiatric Research · doi:10.1016/0022-3956(67)90025-8 · Cited by 25 · see citing works
Luy, M., Flandorfer, P., & Giulio, P. D. (2013) · Ageing and Society · doi:10.1017/s0144686x13000421 · Cited by 18 · see citing works
Ottmann, G., & Maragoudaki, M. (2014) · Ageing and Society · doi:10.1017/s0144686x14000828 · Cited by 11 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Factors impacting resilience as a result of exposure to COVID-19: The ecological resilience model
Panzeri, A., Bertamini, M., Butter, S., Levita, L., Gibson-Miller, J., Vidotto, G., Bentall, R. P., & Bennett, K. M. (2021) · PLoS ONE · doi:10.1371/journal.pone.0256041 · Cited by 99 · see citing works
“Following the concept analysis and definition developed by Windle [11], Windle and Bennett [21] developed the ecological model of resilience (Fig 1) which was originally developed in relationship to caregiving but has subsequently been used in other contexts, for example amongst older people living in poverty in Colom…”
MethodInfluentialBelongingness challenged: Exploring the impact on older adults during the COVID-19 pandemic
Derrer‐Merk, E., Ferson, S. A., Mannis, A., Bentall, R. P., & Bennett, K. M. (2022) · PLoS ONE · doi:10.1371/journal.pone.0276561 · Cited by 30 · see citing works
Koivunen, K., Portegijs, E., Sillanpää, E., Eronen, J., Kokko, K., & Rantanen, T. (2021) · Quality of Life Research · doi:10.1007/s11136-021-03002-0 · Cited by 29 · see citing works
Resilience in relation to older adults with multimorbidity: A scoping review
Seong, H., Lashley, H., Bowers, K., Holmes, S., Fortinsky, R. H., Zhu, S., & Corazzini, K. (2022) · Geriatric Nursing · doi:10.1016/j.gerinurse.2022.08.017 · Cited by 20 · see citing works
Bennett, K. M., Panzeri, A., Derrer‐Merk, E., Butter, S., Hartman, T. K., Mason, L., McBride, O., Murphy, J., Shevlin, M. E., Miller, J. G., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0283254 · Cited by 19 · see citing works
Stenroth, S. M., Pynnönen, K., Haapanen, M. J., Vuoskoski, P., Mikkola, T. M., Eriksson, J. G., & von Bonsdorff, M. B. (2023) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2023.105119 · Cited by 17 · see citing works
Whitmore, C., Markle‐Reid, M., McAiney, C. A., Fisher, K., & Ploeg, J. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-03726-3 · Cited by 17 · see citing works
‘I have never bounced back’: resilience and living with dementia
Windle, G., Roberts, J. R., MacLeod, C. A., Algar-Skaife, K., Sullivan, M. P., Brotherhood, E., Ch, J., & Stott, J. C. H. (2023) · Aging & Mental Health · doi:10.1080/13607863.2023.2196248 · Cited by 15 · see citing works
Self-citationZulkifli, M. M., Rahman, R. A., Muhamad, R., Kadir, A. A., Roslan, N. S., & Mustafa, N. (2024) · BMC Psychology · doi:10.1186/s40359-024-02296-2 · Cited by 17 · see citing works
Qiu, Y., Cong, Z., Wang, X., & Li, S. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04575-w · Cited by 11 · see citing works
Wister, A., Li, L., Ferris, J. K., Kim, B., Klasa, K., & Linkov, I. (2024) · BMC Public Health · doi:10.1186/s12889-024-19992-8 · Cited by 11 · see citing works
Mawila-Chauke, D. (2023) · African Journal of Disability · doi:10.4102/ajod.v12i0.1045 · Cited by 10 · see citing works
Bosio, C., Usta, D., Leo, D. G., Trevisan, C., Lane, D. A., & Graffigna, G. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-094351 · Cited by 6 · see citing works
Whitmore, C., Markle‐Reid, M., Fisher, K., Ploeg, J., McAiney, C. A., Griffith, L. E., Phillips, S. P., & Wister, A. (2021) · International Journal of Qualitative Methods · doi:10.1177/16094069211050166 · Cited by 6 · see citing works
Three Years Later: A Reflection on Korean Social Work During the COVID-19 Pandemic
Lee, J., Chun, J., Jang, J., & Bonano-Broussard, D. (2024) · Journal of Social Service Research · doi:10.1080/01488376.2024.2339969 · Cited by 3 · see citing works
Cocota's Story: Life Lessons in Aging, Resilience, and End‐of‐Life Agency From a Brazilian Matriarch
Avelino‐Silva, T. J., & Moini, N. (2025) · Journal of the American Geriatrics Society · doi:10.1111/jgs.19566 · Cited by 2 · see citing works
Resilience Trajectories Among Older Adults With Disabilities: A Longitudinal Study in Anhui, China
Qiu, Y., Bi, J., Li, S., & Cong, Z. (2025) · Research on Aging · doi:10.1177/01640275251339996 · Cited by 1 · see citing works
Resilience Among Survivors of Human Trafficking in Uganda: A Mixed Methods Study
Nkwanzi, V., Bulamba, R., Akello, D., Namakula, S., Stahnke, B., Evans, D., Kyasanku, E., Menya, E., Daama, A., Mugamba, S., et al. (2026) · Journal of Interpersonal Violence · doi:10.1177/08862605261426601 · Cited by 1 · see citing works
Mawila-Chauke, D. (2022) · African Journal of Disability · doi:10.4102/ajod.v11i0.1045 · Cited by 1 · see citing works
Partner Caregiver Resilience: A Scoping Review
Burton, S. D., Ailey, S. H., & Paun, O. (2024) · Research in Gerontological Nursing · doi:10.3928/19404921-20240206-01 · Cited by 1 · see citing works
Ryan, S., Barry, L. A., Fitzgerald, C., Galvin, R., & Doody, O. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06401-x
Towards a Theory of Older Adults’ Well-Being During the COVID-19 Pandemic: A Qualitative Approach
Derrer‐Merk, E., Reyes, M. F., Navarro‐McCarthy, A., Mulenga-Wincierz, M., & Bennett, K. M. (2026) · Journal of Ageing and Longevity · doi:10.3390/jal6010018
Cornu, T., Marchal, B., Keune, H., Remmen, R., Delbaere, B., & Michielsen, J. (2026) · BMC Geriatrics · doi:10.1186/s12877-026-07122-5
Psychological Resilience Across the Lifespan and in Diverse Communities
Chenji, S. G., & Ghosh, S. (2026) · IGI Global eBooks · doi:10.4018/979-8-2600-3085-1.ch001
Songsri, C., Ramluggun, P., & Aryuwat, P. (2026) · Geriatrics · doi:10.3390/geriatrics11040111
Social Dimensions of Resilience in Older Adults: A Systematic Review
Ruokosuo, E. S., Rostgaard, T., Perek-Białas, J., & Timonen, V. (2026) · Health & Social Care in the Community · doi:10.1155/hsc/3211500
Lou, C., Yang, J., Wang, Y., Han, H., Lu, W., Zhang, N., Feng, Y., Lian, H., Zhao, Y., Johansson, L., et al. (2026) · Geriatric Nursing · doi:10.1016/j.gerinurse.2026.104377
- Authors
- Windle, G., Bennett, K. M., MacLeod, C., & The CFAS WALES research team
- Affiliations
- Bangor University (GB)
- University of Liverpool (GB)
- Corresponding author
- Windle, Gill
- Venue
- Frontiers in Medicine
- Publisher
- Frontiers Media SA
- Published
- 2020-09-22
- Volume
- 7
- Pages
- 502314-502314
- ISSN
- 2296-858X (ISSN-L)
- PMC
- PMC7536341
- OpenAlex
- W3088751414
- Cited by
- 27
- References
- 49
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 3
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Bangor University Research Portal (Bangor University) (submittedVersion, other-oa)
- Funders
- Economic and Social Research Council
- Topics
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Keywords
- resilience, older adults, comorbidities, life experience, well-being, bereavement, loss, illness, caring experience, self-identity, meaningful relationships, sense of belonging, life course, healthy aging, protective factors, human agency
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
