Differential relationships between physical activity and mental health among adults with disabilities in Korea

Although prior studies suggest physical activity (PA) benefits the mental health of the general population, evidence remains scarce for people with disabilities, who are comparatively less active and at greater risk of mental health disorders (MHD). This study aimed to assess the differential associations between PA and mental health outcomes among Korean adults with disabilities. This study drew on nationally representative data from the Korea Health Panel Survey (KHPS, 2019–2021, Version 2.2), including 1,890 adults with disabilities. PA levels were assessed per WHO guidelines as insufficient ( 300 min/week). In this study, participants engaging in ≥ 150 min of PA per week were defined as physically active. MHD included stress, anxiety, depression, and suicide ideation. Multivariable logistic regression analyses adjusted for covariates were performed, along with stratified interaction analyses, to examine the associations between PA and each mental health outcome. Overall, 51.5% (95% CI: 49.3–53.8) of participants were physically active. Adults with disabilities engaging in moderate and/or high PA exhibited lower odds of stress (OR, 95% CI; moderate PA: 0.55, 0.36–0.85; high PA: 0.61, 0.44–0.91) and suicide ideation (OR, 95% CI; moderate PA: 0.62, 0.34–0.98) compared to those with insufficient PA. High PA was associated with a 52% reduction in the odds of depression (OR, 95% CI: 0.48, 0.25–0.93). Physically active adults with physical (suicide ideation, OR, 95% CI: 0.38, 0.20–0.84), sensory (stress, OR, 95% CI: 0.49, 0.17–0.97), and internal organ disabilities (OR, 95% CI: stress, 0.27, 0.14–0.73; anxiety, 0.60, 0.26–0.97) exhibited lower odds of MHD. Older adults, males, employed individuals, urban residents, and those with higher educational attainment or chronic health conditions who were physically active demonstrated a stronger protective association with MHD. The findings indicate a positive association between sufficient PA and mental health among adults with disabilities. Notably, the positive association between PA and mental health was particularly pronounced among individuals with physical, sensory, and internal organ disabilities. These findings support tailored PA interventions as a public health strategy to enhance mental well-being in disabled individuals, with further research needed to explore underlying mechanisms and develop accessible programs addressing diverse disability needs. Not applicable.