ArticleJournal of multidisciplinary healthcare2026
Association Between Physical Activity and Anxiety in A Rural Chinese Middle-Aged and Older Cohort.
Article in Journal of multidisciplinary healthcare, 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 China's population ages, the burden of anxiety is increasing. Physical activity (PA) is a cost-effective lifestyle factor, but its associations with mental health differ by domain and volume. Methods: This cross-sectional study included 4394 rural middle-aged and older adults (mean age 56.67±8.73 years) from the Yangzhou Upper Gastrointestinal Disease Screening Cohort. PA was assessed using a questionnaire based on the International Physical Activity Questionnaire (IPAQ), and anxiety was measured with the 7-item Generalized Anxiety Disorder Scale (GAD-7). Logistic regression and restricted cubic spline (RCS) models were used to examine associations and nonlinear patterns. Sensitivity analyses assessed robustness. Results: Domain-specific associations with anxiety were observed. After confounder adjustment, each 1-SD increase in total physical activity (TPA) and occupational physical activity (OPA) was associated with 22% higher odds of anxiety (both OR=1.22, 95% CI: 1.11-1.34, P<0.001). Household physical activity (HPA) showed a marginally positive association (OR=1.10, 95% CI: 1.00-1.21, P=0.050), whereas leisure-time physical activity (LTPA) was inversely associated (OR=0.88, 95% CI: 0.80-0.96, P=0.004). RCS analysis further revealed reverse L-shaped dose-response relationships for TPA and OPA, with inflection points at 7098.72 and 4200.11 MET-min/week, respectively. Conclusion: We found that the relationship between PA and anxiety was domain-specific. OPA was positively associated with anxiety above a certain threshold, whereas LTPA was inversely associated. HPA showed only a weak positive association. Public health strategies should distinguish between activity domains and population characteristics, and implement targeted interventions for anxiety.
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