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

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

摘要

目的: 从4种不同的肥胖指标的角度出发，探索心理韧性与全因死亡率在中国老年人群中的潜在差异，以发现更值得关注的亚群。方法: 中国老年健康影响因素跟踪调查2011—2012年招募的7 481例老年人被纳入该研究。建立Cox风险比例回归模型探索心理韧性与老年人全因死亡率的关联。亚群疗效评估模式图用于探索心理韧性在中国老年人群中的异质性。结果: 在中国老年人群中，更高的心理韧性将使全因死亡率降低(P<0.001)。心理韧性对全因死亡率的影响在基于身体指数、体圆指数、腰高比和体重指数划分的亚人群间的差异具有统计学意义(P<0.001)。结论: 心理韧性与中国老年人的全因死亡率的关联强度在不同亚群间存在异质性。多个指数评估为超重的老年人更需要保持良好的心理韧性以降低全因死亡风险。

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.

关键词

心理韧性 / 心理健康 / 肥胖 / 死亡率 / 老年人

Key words

psychological resilience / mental health / obesity / mortality / old adult

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基金资助

江苏省预防医学科研课题(YM2023103)

江苏省科技资源(重大疾病生物样本)统筹服务平台开放课题(TC2023B010)

江苏省中医疫病研究中心开放课题(JSYB2024KF17)

江苏省中药特色制剂融合创新中心(K2024J02)