Physical Activity and Chronic Diseases: A Cross-sectional Study of 19,084 Middle-aged and Elderly Chinese

Abstract Background: Regular physical activity is beneficial for both physical and mental health, yet studies on the levels of physical activity among the elderly in China are relatively scarce, and the health benefits of different levels of physical activity remain unclear. Objective: To investigate the levels of physical activity among the elderly in China and to analyze the association between different levels of physical activity and 15 chronic diseases using multinomial logistic regression. Methods: The participants (N=19084) were drawn from the China Health and Retirement Longitudinal Study data, a nationally representative survey designed to collect high-quality microdata on households and individuals aged 45 and over, covering 28 provinces in China. We used the latest survey data from 2020 to describe the participation in physical activity among the middle-aged and elderly population in China using frequencies and percentages, and to explore the differences in the prevalence of chronic diseases among different levels of physical activity using multinomial logistic regression. Results: Of the 19084 participants, 8750 (45.8%) met the recommended levels of physical activity guidelines（level3）, 8159 (42.8%) did not meet the recommended levels（level2）, and 2175 (11.4%) did not participate in any form of physical activity（level1）. Compared to those who did not participate in physical activity（level1）, those who participated but did not meet the guidelines（level2） had a reduced risk of 8 types of chronic diseases, including hypertension (OR=0.92, CI: 0.83-1.01) and stroke (OR=0.70, CI: 0.61-0.82). Among those who met the guidelines（level3）, compared to those who did not participate in physical activity（level1）, there was a reduced risk of 11 types of chronic diseases, including hypertension (OR=0.73, CI: 0.66-0.80) and stroke (OR=0.42, CI: 0.36-0.50). Compared to those who did not meet the physical activity guidelines（level1+level2）, those who met the guidelines（level3） had a reduced risk of 10 types of chronic diseases, including hypertension (OR=0.78, CI: 0.73-0.83) and stroke (OR=0.55, CI: 0.48-0.62). Discussion: More than half of the elderly in China (54.2%) do not meet the physical activity guidelines. Participating in physical activity, even if not meeting the guidelines, can reduce the risk of chronic diseases, but adhering to the guidelines for physical activity offers greater health benefits. It is recommended that the Chinese government create favorable conditions for the elderly to participate in physical activities to further increase the proportion of the elderly population meeting the physical activity guidelines.