Impact of change in psychological resilience on subsequent all-cause and cause-specific mortality in community-dwelling older adults: a nationwide cohort study

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2025-06-24 DOI:10.1016/j.puhe.2025.105833

Chi Zhang , Anying Bai , Wenyu Li , Qingqing Wang , Siwei Liu , Miao Miao

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引用次数: 0

Abstract

Objective

Psychological resilience, commonly conceptualized as the capacity to rebound or surmount various forms of adversity, reflects the dynamic adaptability to the aging process. This study examines the impact of change in psychological resilience on all-cause and cause-specific mortality in older adults.

Study design

Prospective cohort study.

Methods

7311 older individuals (mean age 79.61 ± 10.66 years, 53.39 % female) were enrolled from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Psychological resilience was assessed using a 7-item scale in two consecutive waves (2002 and 2005), and survival information was collected in subsequent four follow-up waves (2008, 2011, 2014, and 2018). Participants were classified based on change patterns of psychological resilience: sustained high resilience (n = 3140), resilience decrease (n = 1690), resilience increase (n = 1149), and sustained low resilience (n = 1332). Cox proportional hazards models adjusted for demographic characteristics, health behaviors, and health conditions were employed to assess mortality risk.

Results

Over 34946.58 person-years of follow-up [median: 3.5 (1.51–6.59) years], 4238 deaths were documented including 987 from cardiovascular diseases (CVD). Compared to sustained low resilience group, fully adjusted hazard ratios (HRs) for all-cause mortality were 0.76 (95 % CI: 0.70–0.83) for sustained high resilience group, 0.98 (95 % CI: 0.90–1.08) for resilience decrease group, and 0.80 (95 % CI: 0.72–0.88) for resilience increase group. Similar trends were observed for CVD and non-CVD mortality risks in all participants. Sensitivity and subgroup analyses consistently supported these findings.

Conclusion

Maintaining and enhancing resilience is linked to reduced mortality risks among older adults. These findings underscore the potential benefits of integrating resilience-focused interventions into public health initiatives to promote healthy aging.

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在社区居住的老年人中，心理弹性变化对随后全因和特定原因死亡率的影响：一项全国性队列研究

心理弹性，通常被定义为反弹或克服各种形式逆境的能力，反映了对衰老过程的动态适应性。本研究探讨了心理弹性变化对老年人全因死亡率和特定原因死亡率的影响。研究设计前瞻性队列研究。方法从中国健康寿命纵向调查（CLHLS）中纳入7311名老年人（平均年龄79.61±10.66岁，女性53.39%）。采用7项量表对连续两波（2002年和2005年）的心理弹性进行评估，并在随后的四波（2008年、2011年、2014年和2018年）中收集生存信息。根据心理弹性的变化模式对参与者进行分类：持续高弹性（n = 3140）、持续低弹性（n = 1690）、持续高弹性（n = 1149）和持续低弹性（n = 1332）。采用调整了人口统计学特征、健康行为和健康状况的Cox比例风险模型来评估死亡风险。结果在34946.58人年的随访中[中位数：3.5（1.51-6.59）年]，记录了4238例死亡，其中987例死于心血管疾病（CVD）。与持续低恢复力组相比，持续高恢复力组全因死亡率的完全校正危险比（hr）为0.76 (95% CI: 0.70-0.83)，恢复力降低组为0.98 (95% CI: 0.90-1.08)，恢复力增加组为0.80 （95% CI: 0.72-0.88）。在所有参与者中，心血管疾病和非心血管疾病死亡风险的趋势相似。敏感性和亚组分析一致支持这些发现。结论保持和增强适应力与降低老年人死亡风险有关。这些发现强调了将以恢复力为重点的干预措施纳入公共卫生举措以促进健康老龄化的潜在益处。

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.