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

IF 4.7 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2026-01-01 Epub Date: 2025-09-29 DOI:10.1016/j.archger.2025.106047

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.

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日常生活活动和心理弹性对中国老年人全因死亡率和认知障碍的相互作用：基于CLHLS的队列研究

目的：探讨心理弹性（PR）和日常生活活动（ADL）对认知功能障碍和全因死亡率的共同影响和相互作用。方法：从中国健康长寿纵向调查中招募中国老年人。采用Cox比例风险回归和对数二项回归来估计暴露与全因死亡率和认知功能障碍之间的关系（定义为MMSE评分）结果：与正常ADL和高PR的参与者（1组）相比，有限ADL和高PR的参与者（3组，HR = 2.105; 95% CI: 1.656, 2.676）和有限ADL和低PR的参与者(4组，HR = 3.076；95% CI: 2.436, 3.884)显示全因死亡风险显著增加。此外，ADL和PR对全因死亡率的协同作用表现为相互作用的相对超额风险（RERI = 0.824; 95% CI: 0.363, 1.286）、相互作用的归因比例（AP = 0.268; 95% CI: 0.121, 0.415）和协同作用指数（SI = 1.659; 95% CI: 1.134, 2.426）。在认知障碍方面，与1组相比，3组（RR = 1.662; 95% CI: 1.073, 2.576）和4组（RR = 2.138; 95% CI: 1.399, 3.8）的风险增加。此外，亚组分析显示，认知障碍的加性相互作用仅在男性中显著。结论：有限的ADL和低PR共同增加了中国老年人认知功能障碍和全因死亡率的风险，并在全因死亡率中观察到协同加性相互作用。

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.