Perceived health exposure to mega sporting event and depressive symptoms in older adults: the mediating roles of physical activity and loneliness

Mega sporting events are increasingly discussed for their potential public health legacy, yet evidence on their mental health relevance among older adults and the underlying pathways remains limited. This study examined the association between perceived health-related exposure to a mega sporting event and depressive symptoms in community-dwelling older adults, focusing on the roles of physical activity and loneliness. This cross-sectional survey was conducted between October and November 2025 in 10 community health service centers in Luohu District, Shenzhen, China. A total of 961 adults aged 60 years and older were included. Depressive symptoms were assessed using the 5-item Geriatric Depression Scale. Perceived event-related health exposure was assessed using a context-specific five-item indicator reflecting event-related health information exposure. Physical activity was measured using the Physical Activity Rating Scale–3 and loneliness using the 3-item UCLA Loneliness Scale. Multivariable regression and serial mediation analysis with 5,000 bootstrap resamples were performed, adjusting for sociodemographic characteristics, self-rated health, and chronic disease status. Among the 961 participants, 258 individuals (26.85%) met the criteria for depressive symptoms. Higher perceived event-related health exposure was associated with lower depressive symptom scores (B = − 0.045). Indirect effects were observed via physical activity (B = − 0.021) and loneliness (B = − 0.006), as well as via a sequential pathway linking higher perceived exposure to higher physical activity, lower loneliness, and lower depressive symptoms (B = − 0.004). Overall, indirect effects accounted for 68.9% of the total effect. Findings were consistent in sensitivity analyses using binary depressive symptoms. Higher perceived event-related health exposure was associated with fewer depressive symptoms among older adults, with physical activity and loneliness indicating behavioral and psychosocial pathways. These findings may inform consideration of physical activity promotion and social connectedness in planning the public health implications of large-scale sporting events for aging populations. Not applicable.