Page 99 - 南京医科大学自然版

第46卷第8期 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
2026年8月 研究［J］. 南京医科大学学报（自然科学版），2026，46（8）：1197-1210 ·1205 ·

A B
HR LCI UCI 1.10 HR LCI UCI
1.10
（95%CI） 1.05 0.99 1.03 1.02 0.98 0.95 0.95 0.96 0.94 （95%CI） 1.05 1.02 1.01 1.02 1.02 0.97 0.99 1.00 1.01
1.00
1.00
0.92 0.91
0.92
0.92
0.91
0.91
0.95
0.95
0.89
0.89
0.90
0.87 0.88
0.87
Hazard ratio 0.95 0.80 0.82 0.81 0.78 0.85 0.85 0.86 0.85 Hazard ratio 0.95 0.82 0.82 0.82 0.82 0.78 0.79 0.80 0.80
0.85
0.85
0.78
0.82
0.77
0.76
0.82
0.77
0.75
0.70
0.70 0.75
1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8
Subpopulations by median ABSI Subpopulations by median BRI
C D
HR LCI UCI 1.10 HR LCI UCI
1.10
（95%CI） 1.05 0.99 1.00 1.00 1.01 0.97 0.99 0.99 1.00 （95%CI） 1.05 1.02 0.99 1.01 1.02 0.98 0.96 0.96 0.97
1.00
1.00
0.92
0.91
0.91
0.91
0.95
0.95
0.90 0.90
0.90
0.89
0.88
0.89
0.87 0.88
0.88
Hazard ratio 0.95 0.81 0.81 0.81 0.82 0.78 0.79 0.79 0.79 Hazard ratio 0.95 0.83 0.80 0.81 0.82 0.79 0.85 0.85 0.86
0.85
0.85
0.76
0.76
0.76
0.82
0.82
0.75
0.70 0.75
0.70
1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8
Subpopulations by median WHtR Subpopulations by median BMI
A：A body shape index（ABSI）. B：Body roundness index（BRI）. C：Waist⁃to⁃height ratio（WHtR）. D：Body mass index（BMI）.
图5 不同亚群间关联强度异质性的STEPP分析
Figure 5 STEPP analysis for heterogeneity in association strength among different subpopulations
A B
Psychological resilience High Low
60.00 P < 0.001 1.00
P=0.113 P=0.052
（%） 50.00 of （95%CI） 0.90
Cumulative survival rate 30.00 Hazard ratio all⁃cause mortality 0.80
40.00
20.00
0.70
10.00
0.00 0.60
Crude PSM IPW cHR aHR HR_PSM HR_IPW
A：Comparison of all⁃cause mortality rates between high and low psychological resilience groups across crude data，PSM⁃data and IPW⁃data. B：As⁃
sociation between psychological resilience and all⁃cause mortality based on different datasets based on crude data，adjusted data，PSM⁃data，and IPW⁃
data.
图6 经随机森林填补后比较全因死亡率及心理韧性与全因死亡率之间的关联
Figure 6 Comparison of all⁃cause mortality rates and association between psychological resilience and all⁃cause mortality af-
ter being imputed by random forest method
among 7 481 participants from the CLHLS. Our find⁃ resilience and all⁃cause mortality stratified by obesity
ings indicate that psychological resilience was associat⁃ indicators among Chinese older adults.
ed with reduced all⁃cause mortality among Chinese old⁃ Previous studies have consistently demonstrated
er adults. The strength of this association showed het⁃ that psychological resilience is significantly associated
［3，11- 12］
erogeneity across subpopulations. Specifically，the pro⁃ with all⁃cause mortality . In addition，the protec⁃
tective effect of psychological resilience was signifi⁃ tive effect of psychological resilience in older adults ex⁃
cantly greater for overweight older adults. To our hibits an increasing trend with advancing age ［12］ ，under⁃
knowledge，this is the first study focusing on the hetero⁃ scoring the need to prioritize the benefits of psychologi⁃
geneity of association strength between psychological cal resilience within our rapidly aging society. The sig⁃