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

Abstract

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.