Heterogeneity of Association Strength Between Psychological Resilience and All-cause Mortality among Chinese Older Adults: A Prospective Cohort Study
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Jiangsu Provincial Centre for Integration and Innovation in Traditional Chinese Medicine Formulations (k2024J02); Open Project of Jiangsu Province Science and Technology Resources Integrated Service Platform (TC2023B010); Open Project of Jiangsu Provincial Traditional Chinese Medicine Epidemic Disease Research Center (JSYB2024KF17); 2023 Jiangsu Province Preventive Medicine Research Project (Ym2023103)

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    Abstract:

    Aims To explore potential heterogeneity of the association strength between psychological resilience and all-cause mortality based on four obesity indexes, and find the subpopulations wroth great attention. Methods 7481 eligible participants from the Chinese Longitudinal Healthy Longevity Survey surveyed in 2011 to 2012 was included in this cohort study. Cox proportional hazards models were used to analysis the associations between psychological resilience and all-cause mortality. Subpopulation treatment evaluation pattern plot was applied to explore the heterogeneity of the association strength between psychological resilience and all-cause mortality among Chinese older adults. Results Higher psychological resilience was associated with lower risk of all-cause mortality among Chinese older adults (all P < 0.001). The heterogeneity of association strength among different subpopulations based on 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) was statistically significant. Conclusions The association strength between psychological resilience and all-cause mortality was significantly heterogeneous among different subpopulations of Chinese older adults. Older adults classified as overweight via multiple indexes are suggested to maintain greater psychological resilience to decrease the all-cause mortality.

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History
  • Received:October 23,2025
  • Revised:March 24,2026
  • Adopted:July 17,2026
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