Resilience and physical functioning trajectories in people aging with disability: concordance and determinants over seven years.

Background and Objectives: This study sought to estimate trajectories of psychological resilience and physical functioning in adults aging with disability, to examine the alignment of those trajectories, and to explore determinants of trajectory membership over a 7-year span. Research Design and Methods: Data were drawn from a longitudinal survey of 772 adults diagnosed with multiple sclerosis, muscular dystrophy, post-polio syndrome, or spinal cord injury, diagnosed before age 55 and with at least 10 years since diagnosis. Resilience and physical functioning were measured using the Connor-Davidson Resilience Scale and the PROMIS Physical Function Scale. Growth mixture modeling, contingency analysis, and multinomial logistic regression were performed. Results: Participants averaged 55.9 years of age (SD = 10.4) and were 20.9 years since diagnosis. Four distinct trajectories emerged for both resilience (i.e., high-improving, mid-improving, low-stable, very low-stable) and physical functioning (i.e., high-stable, mid-stable, low-stable, very low-declining). Favorable resilience classes were associated with better physical function trajectories, while no individuals with high-improving resilience were classified in the very low-declining physical function class. Approximately one-third of participants concurrently exhibited low resilience and suboptimal physical functioning. Psychological factors predicted resilience trajectories, whereas health-related factors predicted physical functioning trajectories. Self-efficacy was the only determinant significantly associated with both trajectories. Discussion and Implications: Resilience and physical functioning trajectories exhibited significant concordance, suggesting a complex interdependence rather than isolated change processes. The interdependence of these trajectories supports tailored rehabilitation interventions that simultaneously target psychological factors (resilience and self-efficacy) as well as physical function in order to promote successful aging among individuals with compounded age- and disability-related vulnerabilities.