Association between physical activity and psychological resilience in older adults: an analysis of a prospective cohort study in China

Background Although numerous studies have confirmed the mental health benefits of physical activity, evidence on the association between physical activity and psychological resilience—particularly longitudinal evidence that accounts for dynamic patterns of activity change—remains limited. Therefore, this study aimed to examine the cross-sectional and longitudinal associations between physical activity patterns and psychological resilience among older adults in China. Methods This study used two waves of data (2011–2014) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and included Chinese older adults, and employed both cross-sectional and prospective analysis designs. Physical activity was categorized into four patterns of change: consistently inactive, active-to-inactive, inactive-to-active, and consistently active. Psychological resilience was assessed using a five-item scale and dichotomized as high or low. Logistic regression and Cox proportional hazards models were used to examine the associations between physical activity patterns and psychological resilience, adjusting for sociodemographic characteristics, lifestyle factors, and health status. Results In the cross-sectional analysis, compared with the remain-inactive group, the inactive-to-active group (OR = 0.59, 95% CI: 0.51–0.69, p < 0.001) and the remain-active group (OR = 0.61, 95% CI: 0.51–0.72, p < 0.001) had lower odds of low PR, whereas the active-to-inactive group was not significantly associated with low PR (OR = 0.94, 95% CI: 0.77–1.13, p = 0.486). In the longitudinal analysis, the active-to-inactive (HR = 0.73, 95% CI: 0.56–0.96, p = 0.023), inactive-to-active (HR = 0.72, 95% CI: 0.61–0.85, p < 0.001), and remain-active groups (HR = 0.59, 95% CI: 0.48–0.73, p < 0.001) had lower hazards of incident low PR. No statistically significant PA-by-subgroup interactions were detected. Conclusion PA patterns characterized by current activity, regardless of past activity status, were associated with lower odds of prevalent low PR and lower hazards of incident low PR among older adults. These observational findings support further investigation of PA as a potentially modifiable factor associated with psychological resilience.