Heterogeneity in association strength between psychological resilience and all-cause mortality among Chinese older adults: a prospective cohort study

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.

This cohort study included 7481 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.

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).

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.