Longitudinal trajectories of psychological resilience and cognitive impairment among older adults: evidence from a national cohort study

Peicheng Wang, Ruihua Li, Yanhua Chen
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Abstract

Background The relationship between resilience trajectories and cognitive health is not well understood. This study aimed to identify subgroups of psychological resilience trajectories in a national sample of older adults and to examine the association with cognitive impairment over time. Methods This study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018, and 2,788 respondents were included in this prospective analysis. Using a group‐based trajectory modeling approach, we identified resilience trajectory groups within a 6-year period. Cox proportional hazards models were used to assess the relationship between the resilience trajectory groups and cognitive impairment. Results Three distinct trajectories of psychological resilience, including decreasing resilience group (n=131,7.1%), persistent middle resilience group (n=1,808, 58.1%), and persistent high resilience group (n=849, 34.8%). During the 6-year follow-up, compared to those with persistent high resilience, participants with persistent middle resilience (HR = 1.43, 95% CI = 1.14-1.79) and decreasing resilience (HR = 2.46, 95% CI = 1.76-3.43) remained consistent associated with a higher risk of cognitive impairment. Subgroup analysis showed that, the associations between resilience trajectories and cognitive impairment varied by lifestyle and health conditions. Conclusions Psychological resilience is a relatively stable trait among older adults in China, with most individuals maintaining a persistently high or middle level of resilience throughout the follow-up period; however, declining psychological resilience was significantly associated with the risk of cognitive impairment. Therefore, developing targeted interventions to strengthen psychological resilience in older adults is crucial for promoting cognitive health and successful aging, especially for those who have unhealthy lifestyles and with poorer health conditions.
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老年人心理复原力和认知障碍的纵向轨迹:一项全国队列研究提供的证据
背景 抗逆力轨迹与认知健康之间的关系尚不十分清楚。本研究旨在从全国老年人样本中识别心理复原力轨迹的亚组,并研究其与认知障碍随时间变化的关系。方法 本研究使用了2008年至2018年中国健康长寿纵向调查(CLHLS)的数据,共有2788名受访者被纳入此次前瞻性分析。通过基于群体的轨迹建模方法,我们确定了6年内的恢复力轨迹群体。结果 心理复原力有三种不同的轨迹,包括复原力下降组(人数=131,7.1%)、持续中等复原力组(人数=1,808,58.1%)和持续高复原力组(人数=849,34.8%)。在为期6年的随访中,与持续高复原力组相比,持续中等复原力组(HR = 1.43,95% CI = 1.14-1.79)和复原力下降组(HR = 2.46,95% CI = 1.76-3.43)的受试者发生认知障碍的风险仍然较高。分组分析表明,生活方式和健康状况不同,抗逆力轨迹与认知障碍之间的关联也不同。结论 心理复原力在中国老年人中是一个相对稳定的特质,大多数人在整个随访期间都能保持持续的高或中等复原力水平;然而,心理复原力的下降与认知障碍的风险显著相关。因此,制定有针对性的干预措施来增强老年人的心理复原力对于促进认知健康和成功老龄化至关重要,尤其是对于那些生活方式不健康和健康状况较差的老年人。
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