Heterogeneity in association strength between psychological resilience and all - cause mortality among Chinese older adults:a prospective cohort study
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1 Clinical Research Institute, Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Hospital of Traditional Chinese Medicine), Nanjing 210029 ; 2. School of Public Health, Nanjing University of Chinese Medicine, Nanjing 210023 ; 3. GCP Center, Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Hospital of Traditional Chinese Medicine), Nanjing 210029 ; 4. School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023 ; 5. Department of Science and Technology, Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Hospital of Traditional Chinese Medicine), Nanjing 210029 ; 6. School of Public Health, Nanjing Medical University, Nanjing 211166 ; 7. Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Hospital of Traditional Chinese Medicine), Nanjing 210029 , China

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R161.7

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    Abstract:

    Objective: To explore potential heterogeneity in the association between psychological resilience and all-cause mortality across four obesity indices and to identify subpopulations warranting particular attention. Methods: This cohort study included 7 481 eligible participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) surveyed between 2011 and 2012. Cox proportional hazards model was employed to assess the associations between psychological resilience and all-cause mortality. Subpopulation treatment effect pattern plot(STEPP) analysis was further applied to investigate heterogeneity in this association strength among Chinese older adults. Results: Higher psychological resilience was significantly associated with a lower risk of all-cause mortality among Chinese older adults (all P < 0.001). Significant heterogeneity in the association strength was observed across subpopulations defined by a body shape index(ABSI) (P < 0.001), body roundness index(BRI) (P < 0.001), waist-to-height ratio (WHtR) (P < 0.001), and body mass index(BMI) (P < 0.001). Conclusion: The association strength between psychological resilience and all-cause mortality varies significantly among different subpopulations of Chinese older adults. Older adults classified as overweight by multiple indices are encouraged to maintain higher levels of psychological resilience to reduce all-cause mortality risk.

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陈芳怡,王威,胡馨茹,等. 心理韧性与中国老年人全因死亡率关联强度的异质性:一项前瞻性队列研究[J]. 南京医科大学学报(自然科学版),2026,46(8):1197-1210

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History
  • Received:October 23,2025
  • Revised:March 24,2026
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  • Online: August 07,2026
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