ArticleFrontiers in psychology2026
Physical exercise and health-related quality of life in mid- to late-adulthood: a multi-group chain-mediation analysis.
Article in Frontiers in psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: As longevity rises in China, supporting healthy ageing has become imperative. However, the psychological pathways linking physical exercise to health-related quality of life (HRQOL), and whether they differ by gender, remain insufficiently understood. Methods: Using data from 762 adults aged 45 + in Shandong and Hunan, we examined how physical exercise relates to HRQOL and whether psychological resources explain this link. A cross-sectional survey was analyzed with confirmatory factor analysis and structural equation modeling. Bias-corrected bootstraps were used to test indirect and sequential pathways, and multiple-group models compared men and women. Results: Physical exercise showed a positive direct association with HRQOL. This association was jointly mediated by self-esteem and psychological resilience, with the mediators operating both independently and sequentially. The overall pattern was broadly comparable across genders; however, the direct association was stronger among men ( Conclusion: The findings clarify cognitive-affective mechanisms connecting activity to later-life wellbeing and indicate that combining regular exercise with programs that foster self-esteem and psychological resilience is associated with health-related quality of life among middle-aged and older adults. Combining opportunities for regular exercise with programs that cultivate self-esteem and resilience could be an efficient avenue for enhancing HRQOL among middle-aged and older adults.
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