The interaction between activities of daily living and psychological resilience on all-cause mortality and cognitive impairment among Chinese older adults: A cohort study based on CLHLS.
Yingtian Wang, Haining Qi, Xinru Hu, Qian Yu, Manshu Yu, Fan Yang, Xirui Qiu, Fangyi Chen, Ye Ding, Meng Jiang, Xiaoxiao Wang, Li Liu, Wei Wang
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引用次数: 0
Abstract
Objectives: To investigate the joint effects and interactions of psychological resilience (PR) and activities of daily living (ADL) on cognitive impairment and all-cause mortality.
Methods: Chinese older adults were recruited from the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazards regression and log-binomial regression were employed to estimate the associations between exposures and all-cause mortality and cognitive impairment (defined as MMSE score <18 or self-reported dementia). Interactions were test on the basis of multivariable regressions.
Results: Compared to participants with normal ADL and high PR (Group 1), participants with limited ADL and high PR (Group 3, HR = 2.105; 95 % CI: 1.656, 2.676) and those with limited ADL and low PR (Group 4, HR = 3.076; 95 % CI: 2.436, 3.884) showed significantly increased risks of all-cause mortality. Moreover, the synergistic interactions between ADL and PR for all-cause mortality were evidenced by relative excess risk due to interaction (RERI = 0.824; 95 % CI: 0.363, 1.286), attributable proportion due to interaction (AP = 0.268; 95 % CI: 0.121, 0.415) and synergy index (SI = 1.659; 95 % CI: 1.134, 2.426). Regarding cognitive impairment, compared to Group 1, Group 3 (RR = 1.662; 95 % CI: 1.073, 2.576) and Group 4 (RR = 2.138; 95 % CI: 1.399, 3.8) exhibited increased risks. Additionally, subgroup analysis showed additive interaction for cognitive impairment was significant only in males.
Conclusions: Limited ADL and low PR jointly increase the risks of cognitive impairment and all-cause mortality in Chinese older adults, with a synergistic additive interaction observed for all-cause mortality.