Epidemic outbreaks pose significant risks to sustainable urban development, underscoring the critical need to bolster the resilience of old communities, key to urban epidemic prevention. This study introduces a resilience evaluation system tailored for these communities, employs a cloud model-based fuzzy comprehensive evaluation (FCE) method, and selects Fuzhou City for a case study. It evaluates the resilience of three communities, Qixingjing Xincun (A), the Provincial Forestry Department's dormitory (B), and Wufeng Lanting community (C) across five dimensions. By employing system dynamics (SD) model, the study examines the interplay and impact mechanisms of resilience indicators, predicts trends and future developments, and proposes strategies to enhance resilience. Results indicate that: (1) community B exhibits the highest resilience, followed by A and C, validating the FCE method's efficacy; (2) resilience across all dimensions is on the rise, with no signs of plateauing observed; (3) enhancements in resilience are notably impactful in facility (A3), spatial (A1), environmental (A2) and resident resilience (A5) are extremely close to each other in terms of their impacts, while governance resilience (A4) exhibits minimal changes. Offering insightful contributions to the resilience study of old urban communities, this study serves as a guide for future practice in improving public safety and promoting urban development, and insights into universal urban challenges and resilience strategies.