Psychological resilience and cognitive frailty progression among older adults: evidence from China in 2002–2018

OBJECTIVES: This study examines the association between PR and the progression of cognitive frailty among older adults in China. METHOD: Data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted from 2002 to 2018. Cognitive frailty is defined as the presence of both physical frailty and cognitive impairment in older adults without a dementia diagnosis. Fixed-effect models analyzed the relationship between PR and cognitive frailty over time. Latent Class Growth Models were used to study the trajectories of PR and cognitive frailty, and multinomial logistic regression and Cox proportional hazards regression were applied to examine the links between PR trajectories and cognitive frailty progression. RESULTS: An increase of 1 point in the PR score is associated with an 9% reduction in the risk of cognitive frailty (RRR = 0.91, 95% CI: 0.90, 0.93). Compared to participants in the high-level stable PR group, those in the moderate-level declining and low-level rising PR groups faced a greater risk of experiencing a subsequent trajectory of low probability mild cognitive impairment (MCI) along with accelerated frailty, or a higher likelihood of both conditions. CONCLUSION: These findings emphasize the role of promoting psychological resilience in achieving the broader goals of healthy aging.