Background: Participation in leisure-time activities (LTAs) is associated with lower mortality; however, the related mechanisms have not been fully elucidated. The aim of this study was to explore the mediating role of psychological resilience in the relationship between LTAs and all-cause mortality in community-dwelling older adults.
Methods: A total of 33,679 participants who were aged ≥ 60 in the Chinese Longitudinal Healthy Longevity Study from 1998 to 2018 were recruited. The frequency of seven typical LTAs and psychological resilience levels were collected using standard questionnaires at baseline. The mediating role of psychological resilience between LTAs and all-cause mortality was explored using mediated analyses in Cox proportional hazard models.
Results: During 150,208.03 person-years of follow-up, 24,705 deaths were documented. Older adults who engaged in LTAs more frequently had higher levels of psychological resilience. After adjusting for socio-demographics and health-related factors, we observed linear negative associations between leisure activities (P-nonlinear = 0.192) and psychological resilience (P-nonlinear = 0.308) with all-cause mortality in the total sample, respectively. The relationship between LTAs and all-cause mortality was partially mediated by psychological resilience, accounting for 13.61% (95%CI: 11.91-15.31%) of the association. Higher mediated proportions were observed for social activities than for productive activities. The mediating effect remained stable in sensitivity analyses and was more pronounced in the oldest-old (80 + years) and women subgroups.
Conclusions: Psychological resilience mediated the association between LTAs and all-cause mortality. Frequent participation in leisure activities may play a beneficial role in preventing premature death by improving resilience levels in community-dwelling older people.
Keywords: Leisure-time activities; Mediation analysis; Mortality; Psychological resilience.
© 2025. The Author(s).