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SYSTEMATIC REVIEW

A systematic review of the measurement

properties of aspects of psychological capacity
in older adults
Candice Oster1 , Sonia Hines2 , Chris Rissel2 , Dennis Asante2 , Jyoti Khadka1 , Katrin M. Seeher3 ,
Jotheeswaran Amuthavalli Thiyagarajan4 , Christopher Mikton5 , Theresa Diaz6 , Vivian Isaac2,7
1
Caring Futures Institute, College of Nursing & Health Sciences, Flinders University, Adelaide, Australia
2
College of Medicine & Public Health, Flinders Rural and Remote Health, Flinders University, Alice Springs, Northern Territory,
Australia
3
Brain Health Unit, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
4
Ageing and Health Unit, Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization,
Geneva, Switzerland
5
Demographic Change and Healthy Ageing Unit, Social Determinants of Health, World Health Organization, Geneva, Switzerland
6
Epidemiology, Monitoring and Evaluation Unit, Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World
Health Organization, Geneva, Switzerland
7
School of Allied Health, Exercise & Sports Sciences, Faculty of Science & Health, Charles Sturt University, Albury, New South
Wales, Australia
Address correspondence to: Vivian Isaac, School of Allied Health, Exercise & Sports Sciences, Faculty of Science & Health,
Charles Sturt University, PO Box 789, Albury, New South Wales, Australia. Tel: +61260519011. Email: anisaac@csu.edu.au

Abstract
Objective: to examine the measurement properties of instruments that have been used to measure aspects of psychological
capacity in adults aged 60 years and over.
Methods: the databases PsycINFO, MEDLINE, EMCARE and Scopus from 2010 were searched using search terms related
to psychological capacity, older persons and measurement properties. Both data extraction and risk-of-bias assessment were
conducted using the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria
using Covidence software.
Results: the full text of 326 articles were reviewed and a total of 30 studies were included, plus two further articles identified
from reference lists (n = 32). No single instrument measuring psychological capacity was identified. Twenty (n = 20)
instruments were identified that measure seven constructs of psychological capacity: Resilience; Sense of coherence; Hope;
Mindfulness; Optimism; Attachment to life; Emotional regulation.
Conclusions: this systematic review identified potential measures of psychological capacity in older adults. The review will
inform further work to develop a single comprehensive measure of psychological capacity in older adults.
Keywords: healthy ageing, intrinsic capacity, psychological capacity, psychometric property, systematic review, older people
Key Points
• No single measure encompassing the broad concept of intrinsic psychological capacity was identified in the review.
• The review identified 20 instruments measuring 7 constructs of psychological capacity.
• There is lack of definitional clarity of the concept of psychological capacity, requiring further work.

iv67
C. Oster et al.
Introduction
The United Nations Decade of Healthy Ageing (2021–
30) calls for strengthening measurement for monitoring the
healthy ageing and well-being of older people, including
the measurement of psychological capacity [1]. In 2015,
the World Health Organization (WHO) released a public
health framework for healthy ageing [2]. Rather than con-
sidering healthy ageing from the perspective of the presence
or absence of disease, WHO’s functioning-based approach
is oriented around building and maintaining the ability of
older people to be, and to do, the things they have reason
to value. WHO proposes that this ‘functional ability’ is
determined by the ‘intrinsic capacity’ of the individual, the
environments in which they live, and the interaction between
the individual and these environments. Intrinsic capacity is
defined as ‘all the physical and mental capacities’ that an
individual can draw on at any point in time. According to
WHO’s measurement model, intrinsic capacity consists of
five domains, namely cognitive, psychological, locomotor,
sensory and vitality [3].
While there is some clarity on the structure of intrinsic
capacity and its subdomains, clear conceptual and opera-
tional definitions of psychological capacity are still lacking.
WHO states that psychological capacity is ‘mostly related
to emotional functions’, particularly depression, but also
includes aspects such as anxiety, personality characteristics,
coping and mastery [2]. Recent validation studies considered
measures of affect, sleep, depression, self-reported life
satisfaction, locus of control and social participation as
attributes of psychological capacity [3–6]. A growing body of
evidence from positive psychology suggests a broader set of
attributes such as self-efficacy, resilience, hope, optimism,
sense of coherence, autonomy, resourcefulness, identity,
hope, religiosity/spirituality and life valuation [7] are asso-
ciated with older persons’ functional ability and well-being
[8–10].
There is a better understanding of psychometric proper-
ties of measures of depression in older adults; however, the
measurement properties of positive psychological measures
of psychological capacity are poorly understood [11–13]. To
our best knowledge, there are no systematic reviews that
have assessed the measurement properties of instruments
to measure different attributes of psychological capacity.
This review will focus on positive psychological measures
that could then be used to develop sub-dimensions of a
comprehensive measure of psychological capacity. Therefore,
we aim to examine the measurement properties of instru-
ments used to measure different attributes of psychological
capacity in older persons aged 60 years and over. The focus
is on psychological capacity understood as positive states of
mind, characterised by attributes such as resilience, hope,
self-efficacy and optimism.
Aim
The aim of the review was to examine the psychometric
properties of instruments that have been used to measure
iv68
aspects of psychological capacity in adults aged 60 years
and over.
Methods
Search strategy
The databases PsycINFO (OVID interface, 1806 onwards),
MEDLINE (OVID interface, 1946 onwards), EMCARE
(OVID interface, 1995 onwards) and Scopus were searched
using combinations of subject headings and free-text words.
Search terms related to psychological capacity, older per-
sons and measurement properties (see Appendix 1). Refer-
ence lists of included studies were also screened for poten-
tially relevant articles. In addition, websites of two major
institutions (Global Gateway for Ageing https://g2aging.o
rg/ and Maelstrom https://www.maelstrom-research.org/ne
twork/near) that document the measures used in popula-
tion surveys on ageing were searched to identify potential
instruments and manuals. The review was restricted for year
of publication from 2010 onwards. All database searches
were conducted between July and October 2022. The study
protocol is published in PROSPERO (CRD42022299578).
Study selection
Inclusion criteria:
(i) Population: Older adults aged 60 years or over living
in the community or long-term care facilities. Studies
must include ≥50% aged 60 or older.
(ii) Instruments: Tools measuring aspects of psychological
capacity as an individual’s inherent positive psycholog-
ical state were eligible for inclusion.
(iii) Constructs: Constructs were eligible for inclusion if
they measured aspects of positive psychological capac-
ity as positive beliefs, thoughts and feelings that enable
individuals to enhance their physical, mental and social
functioning. In our review, psychological capacity
does not include mood, depression and outcomes.
Furthermore, psychological capacity does not include
individuals’ outcome evaluation of their cognitive
functions, health outcomes, satisfaction, quality of life
or wellbeing. Potential constructs were reviewed, and
consensus was reached through an iterative process
in team meetings based on the following criteria: (a)
positive psychological construct grounded in theory
and research; (b) valid measurement; (c) dynamic
positive state of mind; and (d) have a positive impact
on health and wellbeing.
(iv) Outcomes: Psychometric properties such as internal
consistency, reliability, measurement error, structural
validity, hypothesis testing, cross-cultural valid-
ity, measurement invariance, criterion validity and
responsiveness.
(v) Study types: Peer-reviewed studies that assess one or
more psychometric properties of instruments for mea-
suring psychological capacity in people aged 60 and
over. Only studies published in English were included.
 Measurement properties of aspects of psychological capacity in older adults
Exclusion criteria:
(i) Psychological capacity was measured as proxy (e.g.
caregivers).
(ii) Psychological capacity measurement was a sub-scale,
and the results of the psychometric properties were not
reported separately.
(iii) Those instruments measuring psychological capacities
for specific disease states or situations, such as cop-
ing in cancer or social contact self-efficacy, were not
considered to be eligible for inclusion.
(iv) Unpublished articles, or articles for which the full text
was not available.
(v) Reviews, qualitative studies or protocol articles.
(vi) Non-English language.
Search results were exported to Covidence systematic
review software (Veritas Health Innovation, Melbourne,
Australia) and duplicates removed. Titles and abstracts
were screened for congruence to the inclusion criteria
by two independent reviewers and differences of opinion
adjudicated by a third reviewer where necessary. Full texts
of the remaining citations were retrieved and assessed for
inclusion by two independent reviewers.
Data extraction and risk-of-bias assessment
Both data extraction and risk-of-bias assessment were con-
ducted using the COSMIN (COnsensus-based Standards
for the selection of health Measurement INstruments) cri-
teria [14] using Covidence. Two reviewers independently
extracted and assessed each paper and conflicts were adju-
dicated by a third reviewer.
Data synthesis
Data were collated and described in tables and a narrative
description developed. Findings were made on the qual-
ity (reliability, validity, consistency and responsiveness) of
individual instruments and used to draw conclusions and
make recommendations for future work. The validity and
reliability of each included instrument were summarised
using the updated criteria for good measurement properties
described by Prinsen et al. [15].
Results
Study inclusion
The database searches identified 10,288 potentially relevant
citations. Following removal of duplicates, the title and
abstract of 9,440 citations were checked against the inclusion
criteria. The full text of 326 articles were assessed for congru-
ence with the review and a total of 30 studies were included.
Two further articles were identified from the reference lists of
relevant studies and included for a total of 32. Results of the
search and study selection procedure are shown in (Figure 1).
No single instrument measuring psychological capacity
was identified. Twenty (n = 20) instruments were identified
that measure seven constructs of psychological capacity:
Resilience; Sense of coherence; Hope; Mindfulness; Opti-
mism; Attachment to Life; Emotional regulation.
Characteristics of included studies
Characteristics of the included studies are presented in
Table 1. Most studies (n = 31, 97%) were cross-sectional,
with one cohort study included. The studies were conducted
between 2011 and 2022. The number of participants in the
studies ranged from 64 [16] to 4,604 [17]. The mean age
in the studies ranged from 63 [18, 19] to 86 [20]. There
was a disproportionate ratio of males to females in 23 (72%)
studies with all but three of these having a larger proportion
of female participants. Participants were mainly recruited
from community settings (n = 26, 81%) followed by aged
care facilities (n = 3), hospital (n = 2) and primary care (n = 1).
Eight studies (25%) reported participant health conditions.
The studies were conducted across 17 countries with the
most represented countries being the USA (n = 7), Spain
(n = 4) and China (n = 4). The countries were mostly high
income (n = 25, 78%) (according to the World Bank country
classifications) followed by upper middle-income (n = 6,
19%). One study was conducted in a lower middle-income
country (Iran) and no low-income countries were repre-
sented. The instruments were administered in 11 languages,
most commonly English (n = 10) followed by Chinese (n = 5)
and Spanish (n = 5). Instruments were translated from the
original language in 20 (63%) studies. Only one study was
conducted with Indigenous peoples [21].
Psychometric properties of the instruments most fre-
quently assessed were internal consistency, structural validity
and hypothesis testing (see Table 2). One study assessed
measurement error and no studies assessed responsive-
ness. Assessment of methodological quality is presented
in Table 3. The results of each study on the assessed
measurement properties (following COSMIN guidelines of
good measurement properties; [15]) are presented for each
individual study and pooled results where multiple studies
assessed a single instrument in Table 4. In what follows, we
provide a summary of the psychometric properties of the
instruments across the seven constructs.
Psychological capacity constructs
Resilience
Resilience was the most measured construct, with 11
instruments measured across 19 studies. As with the
other constructs of psychological capacity identified in the
review, there is a lack of definitional consistency relating
to resilience. However, it can be broadly understood as ‘a
dynamic process that results in positive adaptation when
faced with adversity’ [35](p. 215). Three instruments
were measured in multiple studies—the Connor–Davidson
Resilience Scale (CDRS), the Wagnild–Young Resilience
Scale and the Brief Resilient Coping Scale. The CDRS was
assessed in five studies involving 5,215 participants. Two
iv69
C. Oster et al.
Figure 1. PRISMA flowchart.
studies administered the CDRS in the original language
(English) and three administered translated versions.
Overall, the CDRS demonstrated sufficient reliability,
criterion validity and cross-cultural validity/measurement
invariance but insufficient validity across the five studies
focusing on this instrument. A short form of the scale (10
items) showed sufficient reliability and validity in one of the
studies [21].
The Wagnild–Young Resilience Scale was assessed in four
studies involving 4,536 participants. Two studies adminis-
tered it in the original language (English) and one a trans-
lated version. Overall, the scale demonstrated insufficient
reliability and structural validity and sufficient hypothesis
testing and cross-cultural validity/measurement invariance.
A short form of the scale (5 items) showed sufficient reliabil-
ity and validity in one of the studies [33].
iv70
The Brief Resilient Coping Scale was assessed in three
studies involving 1,360 participants. All administered trans-
lated versions (Spanish). Overall, the scale demonstrated
sufficient internal reliability, structural validity and cross-
cultural validity/measurement invariance, with hypothesis
testing assessed as indeterminate. Of the remaining eight
instruments, the Resilience Scale for Oldest-Old Age, The
University of Washington Resilience Scale, the Multidimen-
sional Individual and Interpersonal Resilience Measure, and
the Resilience Scale for Older Adults all showed sufficient
reliability and validity in older people.
Sense of coherence
Sense of coherence, defined as the ‘the ability to iden-
tify and utilise internal and external resources to facilitate
 Table 1. Characteristics of the included studies
Author (date)/country Name of the measure(s) Language/original or Study design Study population Setting Measurement properties
translation
Validity Reliability Other
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Resilience
√ √
Akatsuka & Tadaka (2021) [22] Resilience Scale for Oldest-old Japanese/original Cross- n = 1,283, mean age = 84.7, M = 55.4%, F = 44.6%, 29.0% Community
Japan age (RSO) sectional were certificated for long-term care need, mean number of
diseases = 1.8
√ √
Amtmann et al. (2020) [18] Resilience Item Bank and Short English/original Cross- People with chronic medical conditions: n = 1,441, mean Community
USA Form sectional age = 63, M = 35%, F = 65%; general population: n = 300;
mean age = 49, M = 49%, F = 51%
√ √
Cohen et al. (2017) [23] Wagnild–Young Resilience Scale; English/original Cross- n = 200 older adults, mean age = 80.9 and n = 192 youth, Community
USA Windle–Markland–Woods sectional mean age = 13.2
Psychological Resilience Scale;
Connor–Davidson Resilience
Scale
√ √
da Silva-Sauer et al. (2021) [24] Brief Resilience Scale Brazilian-Portuguese/ Cross- n = 1,251, mean age = 68.02 (SD = 6.52), M = 45.8%, Community
Brazil translation sectional F = 54.2%
√ √
Goins et al. (2012) [21] Connor–Davidson Resilience English (older Cross- n = 160, mean age = 67.9 (SD = 9.9), M = 31.2%, Community
USA Scale American sectional F = 68.8%, 35.6% diagnosed with diabetes, 31.3%
Indians)/original diagnosed with cardiovascular disease, 43.8% had at least
one activity of daily living limitation
√ √ √
Hawkley et al. (2021) [17] 4-item resilience scale English/original Cross- n = 4,604, aged between 50–59 and 80–95 Community
USA sectional
√ √
Li & Ow (2022) Resilience Scale for Older Adults Chinese/original Cross- n = 368, 38.3% aged between 71 and 80, 31.8% aged Aged care
Taiwan [25] (RSOA) sectional between 81 and 91, M = 32.9%, F = 67.1% facility
√ √
Martin et al. (2015) [26] Multidimensional Individual English/original Cross- n = 1,006, mean age = 77.35 (SD = 12.2), M = 51.4%, Community
USA and Interpersonal Resilience sectional F = 48.6%
Measure (MIIRM)
√ √
Meng et al. (2019) [27] Connor–Davidson Resilience Chinese/translation Cross- n = 1,238, mean age = 72.47 (SD = 9.09), M = 42%, Community
China Scale sectional F = 58%
√ √
Moret-Tatay et al. (2015) [19] Brief Resilient Coping Scale Spanish/translation Cross- n = 991, mean age = 62.7 (SD = 5.89), M = 75.9%, Community
Spain sectional F = 24.2%
√ √
Resnick & Inguito (2011) [28] The Resilience Scale English/original Cross- n = 163 residents in a continuing care retirement Community
USA (Wagnild–Young) sectional community setting (mean age = 86.3, SD = 5.8), M = 26%,
F = 74%;
n = 101 older women post-hip fracture (mean age = 80,
SD = 7.6), M = 0%, F = 100%
√ √
Tomas et al. (2012) [29] Brief Resilient Coping Scale Spanish/translation Cross- n = 133, mean age = 71.7 (SD = 6.93), M = 30% F = 70% Community
Spain sectional
√ √
Tomas et al. (2021) [30] Brief Resilient Coping Scale Spanish/translation Cross- Peru sample = 236, mean age = 72.8 (SD = 6.9), M = 21.6% Community
Spain sectional F = 78.4%; Spain sample = 133, mean age = 71 (SD = 7),
M = 30.1%, F = 69.9%
√ √
Tourunen et al. (2021) [31] Connor–Davidson Resilience Finnish/translation Cross- n = 1,018, age 75 (45%), 80 (33%) and 85 (22%), Community
Finland Scale sectional M = 43%, F = 57%
√ √ √
Velickovic et al. (2020) [32] Connor–Davidson Resilience Swedish/translation Cross- n = 2,599, age 45–54 = 330, 55–64 = 737, 65–74 = 1,283, Community
Sweden Scale sectional 75–84 = 249, M = 1,316, F = 1,283
√ √
von Eisenhart Rothe et al. Resilience Scale (Wagnild & German/translation Cross- n = 3,712, median age = 72 (SD = 5.8), M = 48%, F = 52% Community
(2013) [33] Germany Young) sectional
√ √
Whitehall et al. (2021) [34] Making it Clear (MiC) English/original Cross- n = 416, mean age 85.33 (SD = 6.54), M = 134, F = 282 Hospital

iv71
Measurement properties of aspects of psychological capacity in older adults

Scotland sectional
(Continued)
 Table 1. Continued
Author (date)/country Name of the measure(s) Language/original or Study design Study population Setting Measurement properties

iv72
translation
Validity Reliability Other
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
√ √
Wilson et al. (2022) [35] Resilience Scale for Older Adults English/original Cross- Study 1: n = 345, mean age = 65.32 (SD = 4.54), M = 112, Community
Canada sectional F = 231;
C. Oster et al.

Study 2: n = 216, mean age = 71.55 (SD = 7.78), M = 73,

F = 142;
Study 3: n = 365, mean age = 64.01 (SD = 5.31), M = 111,
F = 253
√ √
Yang et al. (2015) [36] Resilience Scale Chinese/translation Cross- n = 461, age 60–88, M = 270; F = 191 Community
China (Wagnild–Young) sectional
Sense of coherence
√ √ √
McGee et al. (2018) [37] Sense of Coherence scale German/translation Cross- n = 268, mean age 66.94 (SD = 8.96), M = 77, F = 191 Community
Switzerland sectional
√ √
Naaldenberg et al. (2011) [38] Orientation to Life Dutch/translation Cross- n = 1,361, mean age = 75 (SD = 6.8), M = 43%, F = 57% Community
The Netherlands Questionnaire (OLQ-13) sectional
√ √
Söderhamn et al. (2015) [39] Sense of Coherence Scale Norwegian/transla- Cross- n = 2069, mean age = 74.5 (SD = 6.9), M = 49.8%, Community
Norway tion sectional F = 50.2%
√ √
von Humboldt & Leal (2015) Orientation to Life Portuguese/transla- Cross- n = 1,291, mean age = 83.9 (SD = 6.68), M = 540, F = 751 Community
[40] Questionnaire (OtLQ) tion sectional
Portugal
Hope
√ √
Chan et al. (2012) [41] Herth Hope Index Chinese/translation Cross- n = 120, aged 60–80, M = 56.7%, F = 42.3%; n = 24 Hospital
Hong Kong sectional participated in retest;
All patients with heart failure
√ √
DiGasbarro et al. (2020) [16] Adult Hope Scale English/original Cross- n = 64, mean age = 74.45 (SD = 10.49), M = 21, F = 43; Aged care
USA sectional 32 had impaired cognitive functioning facility
√ √
Haugan et al. (2013) [20] Herth Hope Index Norwegian/transla- Cross- n = 202, mean age = 85.87, M = 27.7%, F = 72.3%; Aged care
Norway tion sectional Mild–moderate depression (30%); anxiety (12%) facility
√ √
Yaghoobzadeh et al. (2019) [42] Herth Hope Index Persian/translation Cross- n = 500, mean age = 66.2 (SD = 5.76), M = 214, F = 290 Primary care
Iran sectional
Mindfulness
√ √
Brady et al. (2019) [43] Five Facet Mindfulness English/original Cross- n = 210, mean age = 65.51, M = 55%, F = 45%; Community
Australia Questionnaire sectional Five participants reported experiencing at least one stroke.
Nine participants reported the presence of a current mood
disorder
√ √
Caycho-Rodríguez et al. (2021) Mindful Attention Awareness Spanish/translation Cross- n = 323, mean age F = 68.58 (SD = 7.23), mean age Community
[44] Scale (MAAS-5) sectional M = 68.91 (SD = 7.12), M = 162, F = 160
Peru
Optimism
√ √
Huang et al. (2020) [45] Chinese version of the Revised Chinese/translation Cross- n = 342, mean age = 71.99 (SD = 5.62), M = 41.5%, Community
Canada Life Orientation Test (CLOT-R) sectional F = 58.50%
Attachment to Life
√ √
Araújo et al. (2015) [46] Positive Valuation of Life Scale Portuguese/transla- Cross- n = 207, mean age 77.2 (SD = 7.5), M = 78, F = 129 Community
Portugal (Positive VOL) tion sectional
Emotional Regulation
√ √ √
Carvajal et al. (2022) [47] Cognitive Emotion Regulation Spanish/translation Cohort n = 305, mean age = 70.02 (SD = 4.67), M = 65.25%, Community
Spain Questionnaire (CERQ) F = 34.75%. n = 150 took part in the second wave of the
study after a follow-up period of 6 months
 Table 2. Psychometric properties assessed for each measure
Name of measure Psychometric properties assessed in the included studies

Internal Reliability Measurement Structural Hypothesis Cross-cultural validity/ Criterion Responsiveness Other
consistency error validity testing measurement validity
invariance
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Resilience
√ √ √ √ √ √ √
Connor–Davidson Resilience Scale
√ √ √ √
Brief Resilient Coping Scale
√ √ √ √ √
Wagnild–Young Resilience Scale
√ √ √ √
University of Washington Resilience Scale (UWRS)
√ √
Windle–Markland–Woods Psychological Resilience
√ √ √
Resilience Scale for Oldest-old age (RSO)
√ √ √ √
Brief Resilience Scale
√ √ √
4-item resilience scale
√ √ √ √ √ √
Resilience Scale for Older Adults (RSOA)
√ √ √ √
Multidimensional Individual and Interpersonal Resilience Measure
(MIIRM)
√ √ √
Making it Clear (MiC)
√ √ √ √
Resilience Scale for Older Adults
Sense of coherence
√ √ √ √ √
Sense of Coherence Scale
√ √ √ √
Orientation to Life Questionnaire
Hope
√ √ √ √
Herth Hope Index
√ √
Adult Hope Scale
Mindfulness
√ √ √
Five Facet Mindfulness Questionnaire
√ √ √ √
Mindful Attention Awareness Scale (MAAS-5)
Optimism
√ √ √
Chinese version of the Revised Life Orientation Test (CLOT-R)
Attachment to life
√ √ √
Positive Valuation of Life Scale (Positive VOL)
Emotional regulation
√ √ √ √ √
Cognitive Emotion Regulation Questionnaire (CERQ)

iv73
Measurement properties of aspects of psychological capacity in older adults
iv74
Table 3. Risk-of-bias ratings
Name of measure Psychometric properties of the instruments included and rated by the COSMIN checklist

Author Patient reported Content Internal Reliability Measurement Structural Hypothesis Cross-cultural validity/ Criterion Responsive-
C. Oster et al.

outcome measures validity consistency error validity testing measurement Invariance validity ness
development
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Resilience (n = 19 articles)
Connor–Davidson Resilience Scale
Cohen et al. (2017)∗ [23] Very good Very good
Goins et al. (2012) [21] Very good Very good Very good Very good Very good
Meng et al. (2019) [27] Very good Adequate Very good Very good
Tourunen et al. (2021) [31] Very good Inadequate Adequate Doubtful
Velickovic et al. (2020) [32] Very good Very good Doubtful
Brief Resilient Coping Scale
Moret-Tatay et al. (2015) [19] Very good Very good Very good
Tomas et al. (2012) [29] Very good Very good Adequate
Tomas et al. (2021) [30] Very good Very good Adequate
Wagnild–Young Resilience Scale
Cohen et al. (2017)∗ [23] Very good Very good
Resnick & Inguito (2011) [28] Very good Inadequate Adequate Very good
von Eisenhart Rothe et al. (2013) [33] Very good Very good Very good Very good Very good
Yang et al. (2015) [36] Adequate Doubtful Very good Adequate Adequate
Resilience Scale for Oldest-Old Age (RSO)
Akatsuka & Tadaka (2021) [22] Very good Very good Very good Very good
University of Washington Resilience Scale (UWRS)
Amtmann et al. (2020) [18] Very good Adequate Very good Very good Very good
Windle–Markland–Woods Psychological Resilience
Cohen et al. (2017)∗ [23] Very good Very good
Brief Resilience Scale
da Silva-Sauer et al. (2021) [24] Inadequate Very good Very good Very good Very good
4-item Resilience scale
Hawkley et al. (2021) [17] Very good Very good
Resilience Scale for Older Adults (RSOA)
Li & Ow (2022) [25] Very good Adequate Very good Adequate Adequate Very good Doubtful Very good
Multidimensional Individual and Interpersonal Resilience Measure (MIIRM)
Martin et al. (2015) [26] Very good Very good Very good Very good Very good
Making it Clear (MiC)
Whitehall et al. (2021) [34] Very good Adequate Adequate
Resilience Scale for Older Adults
Wilson et al. (2022) [35] Very good Very good Doubtful Very good
Sense of Coherence (n = 4 articles)
Sense of Coherence Scale
McGee et al. (2018) [37] Very good Very good Adequate Adequate
von Humboldt & Leal (2015) [40] Very good Very good Very good
(Continued)
 Table 3. Continued
Name of measure Psychometric properties of the instruments included and rated by the COSMIN checklist

Author Patient reported Content Internal Reliability Measurement Structural Hypothesis Cross-cultural validity/ Criterion Responsive-
outcome measures validity consistency error validity testing measurement Invariance validity ness
development
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Orientation to Life Questionnaire
Naaldenberg et al. (2011) [38] Doubtful Very good Adequate Doubtful
Söderhamn et al. (2015) [39] Very good Very good Very good
Hope (n = 4 articles)
Herth Hope Index
Chan et al. (2012) [41] Very good Very good Very good Very good
Haugan et al. (2013) [20] Very good Very good Very good
Yaghoobzadeh et al. (2019) [42] Very good Very good
Adult Hope Scale
DiGasbarro et al. (2020) [16] Adequate Very good
Mindfulness (n = 2 articles)
Five Facet Mindfulness Questionnaire
Brady et al. (2019) [43] Doubtful Inadequate Very good
Mindful Attention Awareness Scale (MAAS-5)
Caycho-Rodríguez et al. (2021) [44] Inadequate Very good Very good Very good
Optimism
Chinese version of the Revised Life Orientation Test (CLOT-R)
Huang et al. (2020) [45] Very good Very good Adequate
Attachment to Life
Positive Valuation of Life Scale (Positive VOL)
Araújo et al. (2015) [46] Very good Very good Very good
Emotional Regulation
Cognitive Emotion Regulation Questionnaire (CERQ)
Carvajal et al. (2022) [47] Very good Very good Very good Very good

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C. Oster et al.

Table 4. Summary of validity and reliability of the instruments

Name of measure Summary of validity and reliability
Author + = sufficient, − = insufficient, ? = indeterminate
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Resilience (n = 19 articles)
Connor–Davidson Resilience Scale
Internal reliability +
Reliability ?
Structural validity − Hypothesis testing − Criterion validity +
Cross-cultural validity/measurement invariance +
Cohen et al. (2017)a [23] Internal reliability +
Structural validity −
Goins et al. (2012) [21] Internal reliability +
Structural validity − Criterion validity +
Cross-cultural validity/measurement invariance +
10-item version:
Internal reliability +
Structural validity +
Criterion validity +
Cross-cultural validity/measurement invariance +
Meng et al. (2019) [27] Internal reliability +
Reliability ?
Structural validity +
Cross-cultural validity/measurement invariance +
Tourunen et al. (2021) [31] Internal reliability +
Reliability − Structural validity − Hypothesis testing +
Velickovic et al. (2020) [32] Internal reliability +
Structural validity +
Hypothesis testing ?
Brief Resilient Coping Scale
Internal reliability +
Structural validity +
Hypothesis testing?
Cross-cultural validity/measurement invariance +
Moret-Tatay et al. (2015) [19] Internal reliability +
Structural validity +
Hypothesis testing ?
Tomas et al. (2012) [29] Internal reliability +
Structural validity +
Hypothesis testing?
Tomas et al. (2021) [30] Internal reliability +
Structural validity +
Cross-cultural validity/measurement invariance +
Wagnild–Young Resilience Scale
Internal reliability – Reliability ?
Structural validity − Hypothesis testing +
Cross-cultural validity/measurement invariance +
Cohen et al. (2017)a [23] Internal reliability +
Structural validity −
Resnick & Inguito (2011) [28] Internal reliability +
Reliability?
Structural validity − Hypothesis testing +
von Eisenhart Rothe et al. (2013) [33] RS-11:
Internal reliability +
Structural validity − Hypothesis testing +
Cross-cultural validity/measurement invariance +
RS-5 (short form):
Internal reliability +
Structural validity +
Hypothesis testing +
Cross-cultural validity/measurement invariance +
Criterion validity +
Yang et al. (2015) [36] Internal reliability +
Reliability ?
Structural validity −
(Continued)

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 Measurement properties of aspects of psychological capacity in older adults

Table 4. Continued
Name of measure Summary of validity and reliability
Author + = sufficient, − = insufficient, ? = indeterminate
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Resilience Scale for Oldest-Old Age (RSO)
Akatsuka & Tadaka (2021) [22] Internal reliability +
Structural validity +
Hypothesis testing +
University of Washington Resilience Scale (UWRS)
Amtmann et al. (2020) [18] Internal reliability +
Structural validity +
Hypothesis testing +
Criterion validity +
Windle–Markland–Woods Psychological Resilience Scale
Cohen et al. (2017)a [23] Internal reliability − Structural validity −
Brief Resilience Scale
da Silva-Sauer et al. (2021) [24] Internal reliability +
Structural validity +
Hypothesis testing?
Cross-cultural validity/measurement invariance −
4-Item resilience scale
Hawkley et al. (2021) [17] Internal reliability +
Hypothesis testing?
Resilience Scale for Older Adults (RSOA)
Li & Ow (2022) [25] Internal consistency +
Reliability ?
Measurement error ?
Structural validity +
Hypothesis testing ?
Criterion validity +
Multidimensional Individual and Interpersonal Resilience Measure (MIIRM)
Martin et al. (2015) [26] Internal consistency +
Structural validity +
Cross-cultural validity/measurement invariance +
Criterion validity +
Making it Clear (MiC)
Whitehall et al. (2021) [34] Internal consistency +
Structural validity –
Hypothesis testing?
Resilience Scale for Older Adults
Wilson et al. (2022) [35] Internal consistency +
Structural validity +
Hypothesis testing +
Cross-cultural validity/measurement invariance +
Sense of Coherence (n = 4 articles)
Sense of Coherence Scale
Internal consistency +
Structural validity +
Hypothesis testing ?
Cross-cultural validity/measurement invariance +
McGee et al. (2018) [37] Internal consistency +
Structural validity +
Hypothesis testing ?
Cross-cultural validity/measurement invariance +
von Humboldt & Leal (2015) [40] Internal consistency +
Structural validity +
Hypothesis testing +
Orientation to Life Questionnaire
Internal consistency +
Reliability ?
Structural validity +
Hypothesis testing +
Naaldenberg et al. (2011) [38] Internal consistency +
Reliability ?
Structural validity +
(Continued)

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C. Oster et al.

Table 4. Continued
Name of measure Summary of validity and reliability
Author + = sufficient, − = insufficient, ? = indeterminate
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Söderhamn et al. (2015) [39] Internal consistency +
Structural validity +
Hypothesis testing +
Hope (n = 4 articles)
Herth Hope Index
Internal consistency +
Reliability +
Structural validity +
Hypothesis testing +
Chan et al. (2012) [41] Internal consistency +
Reliability +
Structural validity +
Hypothesis testing +
Haugan et al. (2013) [20] Internal consistency +
Structural validity +
Hypothesis testing +
Yaghoobzadeh et al. (2019) [42] Internal consistency +
Structural validity +
Adult Hope Scale
DiGasbarro et al. (2020) [16] Internal consistency +
Hypothesis testing +
Mindfulness (n = 2 articles)
Five Facet Mindfulness Questionnaire
Brady et al. (2019) [43] Internal consistency +
Structural validity +
Hypothesis testing +
Mindful Attention Awareness Scale (MAAS-5)
Caycho-Rodríguez et al. (2021) [44] Internal consistency +
Structural validity +
Hypothesis testing +
Cross-cultural validity/measurement invariance +
Optimism
Chinese version of the Revised Life Orientation Test (CLOT-R)
Huang et al. (2020) [45] Internal consistency +
Structural validity +
Hypothesis testing ?
Attachment to Life
Positive Valuation of Life Scale (Positive VOL)
Araújo et al. (2015) [46] Internal consistency +
Structural validity − Hypothesis testing +
Emotional Regulation
Cognitive Emotion Regulation Questionnaire (CERQ)
Carvajal et al. (2022) [47] Internal consistency +
Reliability +
Structural validity +
Hypothesis testing +
a
Assessed three instruments

successful coping with stressors and maintain and develop Hope

health’ [37] (p. 1438), was measured by two instruments.
The Sense of Coherence Scale was assessed in translated
versions in two studies involving 2,337 participants. The
scale demonstrated sufficient internal consistency, structural
validity and cross-cultural validity/measurement invariance
with indeterminate hypothesis testing. The Orientation to
Life Questionnaire was also assessed in translated versions in
two studies involving 2,652 participants. The scale demon-
strated sufficient internal consistency, structural validity and
hypothesis testing with indeterminate reliability.
Hope, which can be defined as ‘a multidimensional dynamic
life force characterized by a confident, yet uncertain expec-
tation of achieving something good’ [20] (p. 379), was
measured by two instruments. The Herth Hope Index was
assessed in translated versions in three studies involving 822
participants. The scale demonstrated sufficient internal con-
sistency, reliability, structural validity and hypothesis test-
ing. The Adult Hope Scale was assessed in original English
language in one study with 64 participants, demonstrating
sufficient internal consistency and hypothesis testing.

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 Measurement properties of aspects of psychological capacity in older adults
Mindfulness
Mindfulness, defined as a ‘non-judgmental present-moment
awareness and attention’ [43] (p. 549), was measured by
two instruments. The Five Facet Mindfulness Questionnaire
was assessed in original English language in one study with
210 participants and demonstrated sufficient internal consis-
tency, structural validity and hypothesis testing. The Mindful
Attention Awareness Scale was assessed in a translated version
with 323 participants and demonstrated sufficient internal
consistency, structural validity, hypothesis testing and cross-
cultural validity/measurement invariance.
Optimism
Optimism can be defined as ‘having a positive outcome
expectancy for the future’ [20] (p. 2618). One instrument
measuring optimism was identified. The Chinese version of
the Revised Life Orientation Test was assessed in a translated
version with 342 participants and demonstrated sufficient
internal consistency and structural validity but indetermi-
nate hypothesis testing.
Attachment to life
Attachment to life is ‘the subjectively experienced worth of
a person’s life’ [46] (p. 2385). One instrument measuring
attachment to life was identified. The Positive Valuation
of Life Scale was assessed in a translated version with 207
participants and demonstrated sufficient internal consistency
and hypothesis testing but insufficient structural validity.
Emotional regulation
Emotional regulation is linked to coping and includes ‘con-
scious efforts to regulate one’s emotions in the face of
stressful situations’ [47] (p. 413). One instrument measuring
emotional regulation was identified. The Cognitive Emotion
Regulation Questionnaire was assessed in a translated version
with 305 participants and demonstrated sufficient inter-
nal consistency, reliability, structural validity and hypothesis
testing.
Discussion
Psychological capacity is an important domain of the
intrinsic capacity component of healthy ageing identified by
WHO [2]. This systematic review builds on the discussion
of aspects of psychological capacity in older people and how
this could be measured following the WHO baseline report
[2]. No single measure encompassing the broad concept of
intrinsic psychological capacity was identified in the review.
The review identified 20 instruments measuring 7 constructs
of psychological capacity.
The most common definitions of psychological capacity
come from the positive psychology literature and include
hope, optimism, self-efficacy and resilience [7]. We identified
instruments measuring resilience, hope and optimism
in older people; however, measures of self-efficacy were
excluded as they measured self-efficacy in relation to various
diseases/conditions and no studies of the psychometric
properties of measures of general self-efficacy for older
people were identified. We also identified measures of
additional constructs that are consistent with the attributes
of psychological capacity, including sense of coherence,
mindfulness, attachment to life and emotional regulation.
Resilience was the most widely measured construct
in older people with a range of psychometric properties
evaluated. Other constructs were limited to only one or two
studies with further work needed to determine their validity
and reliability. There was also limited research conducted
in lower middle-income countries and no psychometric
research on psychological capacity was identified from low-
income countries. This might be due to the exclusion of non-
English language studies, with 16 studies excluded for this
reason. These were published in Spanish (n = 9), Portuguese
(n = 2), Persian (n = 1), Japanese (n = 1) and Finnish (n = 1).
Of these, eight measured constructs of psychological capacity
consistent with our inclusion criteria.
The definitions of the included constructs show an inter-
connection across constructs and a relationship between
intrinsic capacity, life experience and environmental factors.
There is an apparent relationship between the identified
constructs and resilience, suggesting that resilience might be
an overarching construct of psychological capacity in older
people. However, there is a need for further work to better
define psychological capacity and develop a single measure
for the purposes of WHO reporting.
Limitations
A major limitation of this study was lack of a clear definition
of psychological capacity, which is an area for future research.
For this review, we understood aspects of psychological
capacity as positive states of mind that enable individuals
to enhance their physical, mental and social functioning.
However, we acknowledge there is potential variability and
overlap in the dimensionality of these constructs. For exam-
ple, resilience is a heterogenous construct and may overlap
with self-efficacy and control. In addition, due to limited
resources a further limitation was the exclusion of non-
English language studies. We also acknowledge that the
limited evidence from low–middle-income countries may
restrict our understanding of psychometric properties of the
aspects of psychological capacities in these countries. Future
psychometric studies on psychological capacity should equi-
tably include low- and middle-income countries and thereby
ensure cross-cultural validity and applicability.
Conclusion
This systematic review has identified significant knowledge
gaps in the measurement of psychological capacity in older
people. The lack of definitional clarity of the concept of
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C. Oster et al.
psychological capacity limits our ability to form a clear con-
clusion on the most appropriate measure. While the concept
of resilience stands out as the most widely understood and
researched concept in the psychometric literature, further
work is needed to clarify the concept of psychological capac-
ity and how this could be measured in older people. This is
currently underway through expert consultation to develop
a more definitive definition of the concept of psychological
capacity, underpinned by the findings of this systematic
review.
Supplementary Data Supplementary Data mentioned in
the text are available to subscribers in Age and Ageing online.
Acknowledgement: We would like to thank Ms Siying Li
for her contribution to the initial journal screening for this
study.
Disclaimer: The authors alone are responsible for the views
expressed in this article and they do not necessarily represent
the views, decisions or policies of the institutions with which
they are affiliated.
Data Availability Statement: The data that support the
findings of this study are available in the Supplementary
materials Appendix 1.
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Received 26 February 2023; editorial decision 27 May 2023
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