https://orcid.org/0000-0002-9618-6385
Abstract
Psychological resilience is associated with better physical and mental health, but little is known about its role in cognitive health from an intersectional perspective. This study aimed to assess the relationship between psychological resilience and cognitive function across subgroups of older non-Hispanic Black and White men and women while taking stress exposure into account.
A total of 453 participants (Black men = 87; Black women = 147; White men = 98; White women = 121) from the Michigan Cognitive Aging Project completed the Brief Resilience Scale and a neuropsychological battery. Analyses of variance were used to assess differences in psychological resilience across the intersection of gender and race. Linear regressions assessed relationships between psychological resilience and global cognition, controlling for sociodemographics and discrimination. Interaction terms and stratified regressions characterized these relationships across intersectional groups.
The level of psychological resilience did not differ across intersectional groups despite differences in stress exposure. Higher resilience was associated with better global cognition in the whole sample (β = 0.12, p = .002), but this association was found only among Black men (β = 0.40, p < .001).
Levels of resilience did not differ between Black and White older adults, despite disproportionate stress exposure among Black older adults. Links between psychological resilience and cognition may depend on stressors and resources that are differentially patterned across intersectional groups. Psychological resilience may be particularly important for cognitive health among Black men, who are frequently underrepresented in cognitive aging research.
Background and Objectives
Among older adults, greater perceived stress is associated with worse cognitive health (Aggarwal et al., 2014; Chen et al., 2022; Korten et al., 2017; VonDras et al., 2005; Zaheed et al., 2021; Zuelsdorff et al., 2020). However, individuals may be able to demonstrate resilience in the face of adversity. A focus on psychological resilience, or the ability to “bounce back” after adverse events, opens up additional avenues for prevention (Smith et al., 2008).
Though psychological resilience has been operationalized in disparate ways, these operationalizations represent a similar construct that consistently relates to cognition. Prior work has found better global cognition (Jung et al., 2021) and nonverbal memory (Wingo et al., 2010) among resilient individuals (i.e., those reporting few to no depressive symptoms after an exposure to a stressful event), compared to less resilient individuals. In a longitudinal extension, resilient individuals at baseline showed better global cognition 2 years later compared to less resilient individuals (Yang et al., 2021). In the Health and Retirement Study, greater psychological resilience, defined by a self-report simplified resilience scale that represents successfully adapting to stress, was associated with better baseline cognitive function (Du et al., 2024). In addition to links between psychological resilience and cognition, evidence suggests reporting more psychosocial resources commonly associated with resilience (e.g., social networks, social contact, and social support) is associated with better episodic memory in the face of adversity (McDonough et al., 2023).
Limited evidence from studies of older adults suggests there may be gender differences in psychological resilience. In one study that operationalized psychological resilience as bouncing back from adversity, women demonstrated more psychological resilience than men (Netuveli et al., 2008). Other work suggests women may build more psychological resilience through their activities, including maintaining social connections (MacLeod et al., 2016). Higher resilience among women may relate to gender differences in perceived stress, as individuals experiencing more stress may be more likely to need and cultivate psychological resilience (Harris et al., 2016). Indeed, many studies have found that women report greater perceived stress compared to men (Osmanovic-Thunstrom et al., 2015; Sacco et al., 2014). In response to stress, women may use multiple coping strategies more frequently than men (Rubio et al., 2016), which may be indicative of greater capacity for psychological resilience among women and could have beneficial cognitive consequences.
Few studies have explored gender differences in the relationship between psychological resilience and cognition, but of the studies that did, findings are inconsistent. Women with higher resilience, but not men with higher resilience, demonstrated better global cognition cross-sectionally (Jung et al., 2021). Longitudinally, men with higher resilience, but not women with higher resilience, demonstrated better global cognition 2 years later (Yang et al., 2021). Additional work has found that higher psychological resilience was associated with better cognitive function among older Chinese men and women (Zhang et al., 2023). Even though men and women differed in their level of resilience, the resilience-cognition association was similar. Thus, although differences across genders have been identified, the evidence is mixed and limited.
Even fewer studies have looked at resilience and cognition across race. Structural racism leads to racial patterning of stress exposure. On average, Black individuals experience more chronic stressors (e.g., discrimination and financial insecurity) than White individuals (Brown et al., 2020; Ward & Mengesha, 2013; Watkins, 2012). This disproportionate exposure to stress has been linked to racial disparities in cognition (Chen et al., 2022; Zahodne et al., 2017; Zuelsdorff et al., 2020). Additionally, intersectional findings point to disproportionate exposure to stress among Black women. As Black women hold multiple disadvantaged identities, they may experience more stressors across multiple domains (Perry et al., 2013).
Although research suggests Black individuals experience more stress exposure, they appraise this stress as less upsetting than White individuals (Brown et al., 2020; Morris et al., 2022; Ward & Mengesha, 2013; Watkins, 2012). This pattern of findings points to unique resilience factors among Black individuals, which may reflect life course adaptations to higher stress exposure. Indeed, Black individuals report more early life stress than White individuals (Merrick et al., 2018; Mersky et al., 2021), and more early life stressors have been associated with higher self-reported psychological resilience in later life (Harris et al., 2016).
The literature reviewed above suggests potential differences in socially patterned stress experiences across both gender and race that may be relevant to psychological resilience. Intersectionality theory posits that the dimensionality of identity cannot be sufficiently assessed by the consideration of only one identity (Crenshaw, 1989). Sexism may be perceived as more harmful in the context of racism, and the combination of both is associated with stressful events (Stevens-Watkins et al., 2014). These findings suggest the importance of considering both race and gender in the context of stress, psychological resilience, and cognitive health.
The current study is grounded in the ecological model of resilience, which states that resilience can be conceptualized as a process, outcome, and resource (Aldwin & Igarashi, 2012). Therefore, we investigated intersectional group differences in the relationship between psychological resilience and cognition, as well as in levels of resilience, while taking into account potential differences in stress exposure. In Aim 1, we assessed the relationship between psychological resilience and global cognition across the full sample, controlling for multiple indicators of stress defined by socioeconomic disadvantage and discrimination. We hypothesized that higher psychological resilience would be associated with better cognition. In Aim 2, we explored group differences in psychological resilience and global cognition across intersectional groups. In line with previous studies of gender differences in psychological resilience (Netuveli et al., 2008) and the possibility that greater stress related to a combination of racism and sexism (Stevens-Watkins et al., 2014) could necessitate psychological resilience, we hypothesized that social groups that have been historically marginalized (e.g., Black individuals, women) would report higher psychological resilience. Despite this potential for greater psychological resilience, we hypothesized that historically marginalized groups (e.g., Black individuals, women) would have worse cognition based on the presence of other prominent risk factors that are socially patterned (e.g., other stressors, lower access to resources that promote better cognition). In Aim 3, we examined the relationship between psychological resilience and global cognition across intersectional groups. Considering intersectional differences in exposures to stress (Perry et al., 2013), we hypothesized that Black women would demonstrate the strongest association between higher psychological resilience and better cognition of the intersectional groups.
Research Design and Methods
Participants
Participants recruited for the Michigan Cognitive Aging Project (MCAP) were included in this study. MCAP is a community-based, ongoing longitudinal study that began in 2017 and assesses older adults who are 55 years and older, fluent in English, and do not have a dementia diagnosis at their baseline visit. Baseline data analyzed in the current study were collected 2017–2020. Participants were initially recruited using 2016 voter registration lists linked to 2010 census data across Washtenaw and Wayne counties in Michigan, USA. The sample is balanced racially with a comparable number of participants who identify as non-Hispanic Black (hereafter Black) and non-Hispanic White (hereafter White). Participants have the option of completing study visits in their home or at office space in Detroit, MI, or Ann Arbor, MI (Zahodne, 2021). The study was approved by the University of Michigan Institutional Review Board. Informed consent was obtained for each participant. Data were collected in compliance with the Helsinki Declaration.
Participants were included in the present study if they (1) answered four or more items on the Brief Resilience Scale (BRS) and (2) were not missing more than one cognitive domain score. A total of 16 participants were excluded, as 5 participants were missing all responses to the BRS, 7 participants were missing more than one cognitive domain score, and 4 participants were missing both BRS and at least one cognitive domain score. Thirty-one participants who did not identify as Black or White were excluded from the study due to insufficient sample sizes to study racial and ethnic groups other than Black or White. Thus, the analytic sample included 453 participants.
Measurements
Demographic variables, including gender and race, were self-reported. Participants were asked, “What is your gender,” with possible responses including: male, female, or nonbinary/other. Participants were then asked what race they considered themselves, with the following options: White, Black or African American, American Indian or Alaska Native, Asian, or Native Hawaiian or Other Pacific Islander. Participants also reported their ethnicity as Hispanic or Latino/a or non-Hispanic or Latino/a.
Socioeconomic disadvantage and discrimination were included as indicators of stress exposure. Participants completed the nine-item Major Experiences of Discrimination Scale (Williams et al., 2008). A sum score indicating the number of reported event types (e.g., “For unfair reasons, have you ever not been hired for a job?”) was used. Socioeconomic disadvantage was measured as education and income. Education was self-reported and could range from 0 to 17 years. Participants self-reported annual income considering all possible sources (i.e., wages, pensions, social security, and government assistance). Income was then categorized into 32 bins that ranged from $0 to $250,000+.
The BRS was used to assess psychological resilience against stress. The BRS is a self-reported measure that aims to measure an individual’s ability to “bounce back” after an adverse event (Smith et al., 2008). The scale is geared toward understanding an individual’s overall response to stress, not to quantify specific resources that help an individual cope with the stress. The scale comprises six questions (e.g., “I tend to bounce back quickly after hard times”) to which a participant can respond from strongly disagree (1) to strongly agree (5). The Cronbach’s alpha for the BRS measure was 0.81.
Global cognition was quantified as the average of five cognitive domain factor scores identified in a previous factor analysis (Zahodne, 2021), including episodic memory, executive function, language, visuospatial skills, and processing speed, standardized to the z-score metric. Higher scores on the global cognition composite indicate better cognitive function. Episodic memory included the immediate, delayed, and recognition trials of a modified Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) word list learning task, the immediate and delayed trials of Craft Story and the delayed trial of the Benson Complex Figure. Executive function included Color Trails II, the interference trial for Stroop Color, and Number Span Backward. Language included the Multilingual Naming Test (MINT), the sum of F, A, and S trials of Letter Fluency, and the animal trial of Category Fluency. Visuospatial skills included the copy trial of the Benson Complex Figure Task, the copy trial for the MoCA Cube, and the Judgement of Line Orientation (JOLO). Processing speed included the Symbol Digits Modalities Test, Color Trails I, and the color trial of Stroop.
Statistical Analysis
All statistical analyses were completed in RStudio (Version 2022.12.0+353). For Aim 1, a linear regression evaluated the relationship between psychological resilience and global cognition. The model covaried for age (centered at the sample mean of 63.5), gender (reference was men), race (reference was White), education (centered at the sample mean of 14), income (centered as the sample mean of $40,000–$44,999.99), and discrimination (centered at the sample mean of two life events).
In Aim 2, two separate analyses of variance (ANOVAs) determined group differences in (1) psychological resilience and (2) global cognition. Analyses of covariance (ANCOVAs) assessed these relationships after adjusting for age, education, income, and discrimination. Tukey tests characterized specific intersectional group differences.
For Aim 3, a linear regression including a multiplicative interaction term assessed group differences in the relationship between psychological resilience and global cognition, controlling for age, education, income, and discrimination. Previous literature has demonstrated that White men have less exposure to stress compared to women and Black individuals (Brown et al., 2020; Perry et al., 2013). Thus, White men were set as the reference group. Given the potential for differing covariate effects across groups, subsequent linear regressions stratified by the four intersectional groups controlling for age, education, income, and discrimination characterized within-group relationships. Although the primary focus of the study was on intersectional differences, racial and gender differences are reported in Supplementary Material to allow for comparisons with previous research and demonstrate where taking an intersectional lens may enhance knowledge gained from examining only race or gender.
Results
Participant demographics are available in Table 1. With regard to indicators of stress exposure, there were significant racial group differences across education (F(3, 447) = 25.32, p < .001) and income (F(3, 440) = 32.27, p < .001) such that White men and women had greater income and education. Within racial groups, there were no gender differences in education or income. Black individuals reported more discrimination than White individuals, and Black men reported more discrimination than Black women (F(3, 422) = 11.82, p < .001).
Sample Characteristics
| Whole Sample N = 453 | Black Men N = 87 | Black Women N = 147 | White Men N = 98 | White Women N = 121 | Tukey test | |
|---|---|---|---|---|---|---|
| Mean (SD) | ||||||
| Age at visit | 63.5 (3.2) | 63.9 (2.4) | 63.1 (3.5) | 63.6 (3.3) | 63.8 (3.1) | BM = BW = WM = WW |
| Education | 14.0 (2.2) | 13.1 (2.1) | 13.3 (2.2) | 14.6 (2.0) | 15.0 (2.0) | BM = BW < WM = WW |
| Income | $45,000–49,999.99 | $30,000–34,999.99 | $25,000–29,999.99 | $65,000–69,999.99 | $55,000–59,999.99 | BM = BW < WM = WW |
| Discrimination | 2.0 | 2.9 | 2.1 | 1.7 | 1.6 | BM > BW > WW = WM |
| Brief Resilience scale | 3.7 (1.0) | 3.7 (0.7) | 3.6 (0.8) | 3.7 (0.8) | 3.8 (0.7) | BM = BW = WM = WW |
| Global cognition | 0.0 (1.0) | −0.6 (0.8) | −0.5 (0.8) | 0.5 (0.7) | 0.6 (0.7) | BM = BW < WM = WW |
| Whole Sample N = 453 | Black Men N = 87 | Black Women N = 147 | White Men N = 98 | White Women N = 121 | Tukey test | |
|---|---|---|---|---|---|---|
| Mean (SD) | ||||||
| Age at visit | 63.5 (3.2) | 63.9 (2.4) | 63.1 (3.5) | 63.6 (3.3) | 63.8 (3.1) | BM = BW = WM = WW |
| Education | 14.0 (2.2) | 13.1 (2.1) | 13.3 (2.2) | 14.6 (2.0) | 15.0 (2.0) | BM = BW < WM = WW |
| Income | $45,000–49,999.99 | $30,000–34,999.99 | $25,000–29,999.99 | $65,000–69,999.99 | $55,000–59,999.99 | BM = BW < WM = WW |
| Discrimination | 2.0 | 2.9 | 2.1 | 1.7 | 1.6 | BM > BW > WW = WM |
| Brief Resilience scale | 3.7 (1.0) | 3.7 (0.7) | 3.6 (0.8) | 3.7 (0.8) | 3.8 (0.7) | BM = BW = WM = WW |
| Global cognition | 0.0 (1.0) | −0.6 (0.8) | −0.5 (0.8) | 0.5 (0.7) | 0.6 (0.7) | BM = BW < WM = WW |
Note: BM = Black men; BW = Black women; SD = standard deviation; WM = White men; WW = White women. Global cognition is a composite score of all cognitive domains (e.g., episodic memory, executive function, language, visuospatial skills, and processing speed) that were standardized to z-scores.
Sample Characteristics
| Whole Sample N = 453 | Black Men N = 87 | Black Women N = 147 | White Men N = 98 | White Women N = 121 | Tukey test | |
|---|---|---|---|---|---|---|
| Mean (SD) | ||||||
| Age at visit | 63.5 (3.2) | 63.9 (2.4) | 63.1 (3.5) | 63.6 (3.3) | 63.8 (3.1) | BM = BW = WM = WW |
| Education | 14.0 (2.2) | 13.1 (2.1) | 13.3 (2.2) | 14.6 (2.0) | 15.0 (2.0) | BM = BW < WM = WW |
| Income | $45,000–49,999.99 | $30,000–34,999.99 | $25,000–29,999.99 | $65,000–69,999.99 | $55,000–59,999.99 | BM = BW < WM = WW |
| Discrimination | 2.0 | 2.9 | 2.1 | 1.7 | 1.6 | BM > BW > WW = WM |
| Brief Resilience scale | 3.7 (1.0) | 3.7 (0.7) | 3.6 (0.8) | 3.7 (0.8) | 3.8 (0.7) | BM = BW = WM = WW |
| Global cognition | 0.0 (1.0) | −0.6 (0.8) | −0.5 (0.8) | 0.5 (0.7) | 0.6 (0.7) | BM = BW < WM = WW |
| Whole Sample N = 453 | Black Men N = 87 | Black Women N = 147 | White Men N = 98 | White Women N = 121 | Tukey test | |
|---|---|---|---|---|---|---|
| Mean (SD) | ||||||
| Age at visit | 63.5 (3.2) | 63.9 (2.4) | 63.1 (3.5) | 63.6 (3.3) | 63.8 (3.1) | BM = BW = WM = WW |
| Education | 14.0 (2.2) | 13.1 (2.1) | 13.3 (2.2) | 14.6 (2.0) | 15.0 (2.0) | BM = BW < WM = WW |
| Income | $45,000–49,999.99 | $30,000–34,999.99 | $25,000–29,999.99 | $65,000–69,999.99 | $55,000–59,999.99 | BM = BW < WM = WW |
| Discrimination | 2.0 | 2.9 | 2.1 | 1.7 | 1.6 | BM > BW > WW = WM |
| Brief Resilience scale | 3.7 (1.0) | 3.7 (0.7) | 3.6 (0.8) | 3.7 (0.8) | 3.8 (0.7) | BM = BW = WM = WW |
| Global cognition | 0.0 (1.0) | −0.6 (0.8) | −0.5 (0.8) | 0.5 (0.7) | 0.6 (0.7) | BM = BW < WM = WW |
Note: BM = Black men; BW = Black women; SD = standard deviation; WM = White men; WW = White women. Global cognition is a composite score of all cognitive domains (e.g., episodic memory, executive function, language, visuospatial skills, and processing speed) that were standardized to z-scores.
Aim 1: Resilience and Cognition in the Whole Sample
For Aim 1, higher psychological resilience was associated with better global cognition (β = 0.12, p = .002) in the whole sample, adjusting for covariates.
Aim 2: Differences in Psychological Resilience and Cognition Across Intersectional Groups
Differences in level of the predictor
In an unadjusted ANOVA, there were no differences in BRS scores by intersectional group (F(3, 449) = 1.72, p = .16; Table 1). This result remained even after controlling for age, education, income, and discrimination.
Differences in level of the outcome
The unadjusted ANOVA found intersectional group differences for global cognition (F(3, 449) = 73.99, p < .001; Table 1). As shown in Table 1, White women and White men scored higher than Black men and Black women. No differences were found between White men and White women or between Black men and Black women. These results assessing intersectional group differences remained even after controlling for age, education, income, and discrimination.
Aim 3: Relationship Between Psychological Resilience and Cognition Across Intersectional Groups
Interaction terms comparing the magnitude of the relationship between psychological resilience and global cognition for White men versus each other intersectional group revealed differences for Black men (β = 0.68, p = .003), but not for White women or Black women. In models stratified by intersectional groups, higher psychological resilience was associated with better global cognition only among Black men (β = 0.40, p < .001). Psychological resilience was not associated with global cognition among Black women (β = 0.04, p = .63), White men (β = 0.05, p = .60), or White women (β = 0.14, p = .10). A visual representation of the relationships between psychological resilience and global cognition across each of these groups is depicted in Figure 1.
Relationship between psychological resilience and global cognition across intersectional groups.
Discussion and Implications
This study examined the relationship between psychological resilience and cognition among older Black and White men and women while accounting for group differences in stress exposures. In line with the ecological model of resilience, psychological resilience was conceptualized as a resource in Aims 1 and 3 and an outcome in Aim 2. We found that levels of self-reported psychological resilience did not differ across intersectional groups despite differences in socioeconomic disadvantage and discrimination. Whole-group associations between higher psychological resilience and better cognition masked differential patterns of association across intersectional groups. Resilience-cognition associations were evident for Black men, but not Black women, White women, or White men. These results indicate the particular importance of psychological resilience for Black men’s cognitive health and reveal the benefits of utilizing an intersectional lens in health disparities research.
Psychological Resilience and Cognition
Our findings from the whole sample suggest psychological resilience is associated with better global cognition. These findings are in line with previous work (Du et al., 2024; Jung et al., 2021; Yang et al., 2021). Psychological resilience may help to maintain cognitive health by reducing the negative cognitive impacts of stress. Previous literature has demonstrated the wide-ranging impact of stress across multiple cognitive domains (Aggarwal et al., 2014; Chen et al., 2022; Korten et al., 2017). Stress has also been associated with dysregulation of the HPA axis, loss of hippocampal volume, and smaller prefrontal cortex, leading to cognitive problems (Canet et al., 2019). As the BRS measures resilience against stress, our results suggest psychological resilience may protect against these broad impacts of stress, especially among Black men.
Psychological Resilience and Cognition Across the Intersection of Race and Gender
The finding that there was no difference in resilience to stress across intersectional groups should be interpreted in the context of group differences in exposure to stress (Ward et al., 2019). Due to structural racism, Black older adults experience more stress exposure than White older adults, on average. For example, Black individuals are more likely than White individuals to experience stressors such as housing challenges and financial strain (Brown et al., 2020; Chen et al., 2022; Ward & Mengesha, 2013; Watkins, 2012). In the current study, Black individuals reported lower education and income than White individuals, indicating potential differences in exposure to financial stress. Black participants reported more discrimination than White participants, which is in line with previous studies (Barnes et al., 2004).
The lack of group differences in psychological resilience despite differences in the magnitude and severity of stress exposure could be interpreted as evidence for greater resilience capacity among marginalized social groups. Brown et al. (2020) found that Black older adults appraised stressors as less upsetting than White older adults, which was associated with better episodic memory (Morris et al., 2022). Black older adults may have appraised stressors as less upsetting due to protective factors (i.e., religious involvement, social support; Morris et al., 2022), which may simultaneously build psychological resilience.
Black men demonstrated the largest association between higher resilience and better cognition, whereas there were no associations among the other three intersectional groups. This pattern of results cannot be explained by different sample sizes, as Black men made up the smallest subsample in this study. As shown in Figure 1, White men, on average, demonstrated a relatively high level of cognitive ability regardless of psychological resilience. In contrast, Black men demonstrated lower cognitive scores when self-reported psychological resilience was low. This pattern of results suggests that advantages afforded to White men (e.g., lower exposure to stressors and greater access to resources) may allow them to maintain their cognitive health even in the absence of psychological resilience.
The particular importance of psychological resilience for cognition among Black men may reflect the unique stressors they face. Black men have identified their intersectional identity and fulfilling societal and cultural roles as primary sources of chronic stress (Griffith et al., 2013). In our study, Black men reported an average of three major life events of discrimination, more than that of any other intersectional group. In the United States, Black men also have higher unemployment and incarceration compared to other groups (Carson, 2022; U.S. Bureau of Labor Statistics, 2017). Having psychological resilience to combat these and other unique and salient stressors may positively affect cognitive functioning among Black men.
There may also be differences in coping strategies among Black men versus other groups in the context of low psychological resilience. Resources at the community and contextual levels can provide an opportunity to build resilience, in addition to individual resources (i.e., individual characteristics; Aldwin & Igarashi, 2012). Previous studies have reported greater self-reported use of avoidant emotion-focused coping among Black older adults than White older adults, and these coping strategies have been associated with worse global cognition (Lee et al., 2023). Additionally, women, compared to men, have demonstrated greater variety of coping strategies (Rubio et al., 2016), which may also have greater cognitive benefits. Thus, increasing coping resources among Black men may be particularly important in building resilience, which could be important for cognition later in life (Lee et al., 2023). Importantly, Black men have been disproportionately underrepresented in research, highlighting the need for more studies to interrogate and contextualize results from the current study and to facilitate the translation of research findings into policies and programs to promote health equity. The current results highlight the need to reduce structural barriers to psychological resilience among Black men, as well as the need for within-group studies to identify optimal interventions for building psychological resilience among Black men that align with their strengths and preferences.
Contrary to our hypothesis, White women and Black women showed no associations between psychological resilience and cognition. The lack of association found among White women may be due to their relatively low stress exposure and/or greater access to resources, similar to that of White men. With regard to Black women, who showed no associations between resilience and global cognition despite evidence for greater stress exposure compared to White women and White men (but not Black men), it is possible that the unique stressors experienced by Black women may require them to rely more heavily on effortful coping strategies. For example, Black women reported their specific stressors to be finances, single parenting, and helping their children navigate structural racism (Tipre & Carson, 2022). Uncontrollable stressors may result in effortful coping strategies that may be cognitively taxing, and the reliance on such coping strategies may deplete the benefits of being psychologically resilient (Abrams et al., 2019; Thomas Tobin et al., 2022). For example, the Strong Black Women (SBW) schema denotes a set of cultural expectations to demonstrate resilience and strength. A characteristic of this schema, self-silencing, adds that in being resilient, one cannot show weakness or discuss hardships (Abrams et al., 2014, 2019). The SBW schema has been linked to adverse health outcomes for Black women, including cardiovascular disease (Abrams et al., 2014), which may affect later-life cognitive health. Thus, demonstrating psychological resilience may also take a toll, particularly for Black women.
Although this study has several strengths, a primary limitation is its cross-sectional design. With a cross-sectional approach, we are unable to determine the direction of the relationship between psychological resilience and global cognition. Although the strong evidence base for negative causal associations between stress and cognition supports the underlying hypothesis that resilience against stress could lead to better cognition, it is also possible that better cognitive abilities enable better psychological resilience. Future studies assessing psychological resilience and cognition need to be done longitudinally to better understand the directionality of this relationship. An additional limitation to our study is that our measures of stress exposure do not capture all domains of stress. Future studies should investigate the roles of level and/or type of exposure to a wider variety of stressors, as well as coping strategies and other resources in the associations between psychological resilience and cognition across social groups. Although this work included individuals from two racial backgrounds and genders, future work should expand this study by including individuals holding other identities to understand unique stressors that may affect their psychological resilience and later cognitive health.
Despite these limitations, a strength of our study is its representative sample, which is relatively balanced across the intersectional groups of interest. Additionally, our study leverages a comprehensive neuropsychological battery, which allows for high-quality characterization of cognitive health.
Overall, our findings highlight psychological resilience as a potential protective factor for cognitive health, especially among Black men, who are frequently underrepresented in cognitive aging research. Group differences in links between psychological resilience and cognition could reflect differences in stress exposure and coping resulting from social stratification and gendered racism. Results from this study highlight the importance of an intersectional lens for parsing specific relationships that may be masked when looking at overall group effects. The study demonstrates the need to reduce structural barriers to psychological resilience among Black men, along with other intersectional groups, as well as the need for within-group studies to identify optimal interventions for building psychological resilience that align with each group’s strengths and preferences. It is imperative for additional work to inform public policy on the importance of structural changes aimed at reducing social and health inequalities.
Funding
This work was supported by the National Institute on Aging [grant numbers R01AG082307, K01AG073588 to K. Sol, F31AG077758 to E. P. Morris, P30AG012846, P30AG024824, P30AG053760].
Conflict of Interest
None.
Data Availability
Data, study materials, and analytical methods are available upon request. This study was not preregistered.
