Association between psychological resilience and all-cause mortality in the Health and Retirement Study

Background: Psychological resilience refers to an individual's ability to cope with and adapt to challenging life circumstances and events.

Objective: This study aims to explore the association between psychological resilience and all-cause mortality in a national cohort of US older adults by a cross-sectional study.

Methods: The Health and Retirement Study (2006-2008) included 10 569 participants aged ≥50. Mortality outcomes were determined using records up to May 2021. Multivariable Cox proportional hazards models were used to analyse the associations between psychological resilience and all-cause mortality. Restricted cubic splines were applied to examine the association between psychological resilience and mortality risk.

Findings: During the follow-up period, 3489 all-cause deaths were recorded. The analysis revealed an almost linear association between psychological resilience and mortality risk. Higher levels of psychological resilience were associated with a reduced risk of all-cause mortality in models adjusting for attained age, sex, race and body mass index (HR=0.750 per 1 SD increase in psychological resilience; 95% CI 0.726, 0.775). This association remained statistically significant after further adjustment for self-reported diabetes, heart disease, stroke, cancer and hypertension (HR=0.786; 95% CI 0.760, 0.813). The relationship persisted even after accounting for smoking and other health-related behaviours (HR=0.813; 95% CI 0.802, 0.860).

Conclusions: This cohort study highlights the association between psychological resilience and all-cause mortality in older adults in the USA.

Clinical implications: Psychological resilience emerges as a protective factor against mortality, emphasising its importance in maintaining health and well-being.