More Than 1 in 4 Adults Get No Regular Exercise, Study Shows

Norra MacReady

September 15, 2016

More than 1 in 4 adults in the United States aged 50 years or older reported having engaged in no physical activity within the previous month beyond that required for work, a new study shows.

This translates into 31 million adults who may be considered physically inactive, Kathleen B. Watson, PhD, of the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, and colleagues write.

Such sedentary habits can have serious health consequences, Dr Watson and colleagues warn in an article published online September 15 in Morbidity and Mortality Weekly Report.

"Physical activity can help delay, prevent or manage many of the chronic diseases for which adults aged >50 years are at risk. These diseases can impact the length and quality of life, as well as the long-term ability to live independently," they write.

The data come from the 2014 Behavioral Risk Factor Surveillance System, a state-based, random-digit-dialed telephone survey of noninstitutionalized adults across the United States and the District of Columbia. For this study, inactivity was defined as a "no" response to the question, "During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?"

Study participants were also asked about seven chronic illnesses that exercise is known to help manage or prevent: stroke, coronary heart disease, arthritis, cancer (except skin cancer), diabetes, chronic obstructive pulmonary disease (COPD), and depressive disorder.

The final sample consisted of 276,919 people, including 162,552 women (52.2%). Overall, 27.5% (95% confidence interval [CI], 27.2 - 27.9) reported engaging in no physical activity within the past month. The prevalence of inactivity was higher among women, at 29.4% (95% CI, 29.0 - 29.9), than among men, at 25.5% (95% CI, 25.0 - 26.0).

Inactivity increased with age: among people aged 75 years or older, the prevalence was 35.3% (95% CI, 34.5 - 36.1), compared with 26.9% (95% CI, 26.3 - 27.5) among people aged 65 to 74 years and 25.4% (95% CI, 25.0 - 25.9) among those aged 50 to 64 years.

There was a marked inverse relationship between physical activity and educational level. The prevalence of inactivity was highest among people with less than a high school degree, at 44.1% (95% CI, 42.7 - 45.4); it decreased progressively for high school graduates (34.7%; 95% CI, 34.0 - 35.3) and people with some college (24.6%; 95% CI, 24.0 - 25.2), and reached a low of 14.2% (95% CI, 13.8-14.7) among those with a college degree.

Inactivity was more prevalent among Hispanics (32.7%; 95% CI, 31.0 - 34.5) and non-Hispanic blacks (33.1%; 95% CI, 31.8 - 34.3) than non-Hispanic whites (26.2%; 95% CI, 25.9 - 26.5) or people of other races or ethnicities (27.1%; 95% CI, 24.9 - 29.5). It was also higher among people who were obese, defined as having a body mass index (BMI) of at least 30 kg/m2 (35.8%; 95% CI, 35.1 - 36.4), compared with those with a BMI <25.0 kg/m2 (23.1%; 95% CI, 22.5 - 23.7).

Inactivity was also more prevalent among those with chronic illness. This was especially the case with COPD (44.4%; 95% CI, 43.3 - 45.5) vs 25.6% (95% CI, 25.2 - 25.9) among people without COPD, and stroke (42.9%; 95% CI, 41.3 - 44.5), vs 26.7% (95% CI, 26.3 - 27.0) among people with no history of stroke.

"Overall, more adults reporting at least one chronic disease were inactive (31.9%) compared with those not reporting any (19.2%)," the authors write.

In a regional analysis, the prevalence of inactivity was lowest in the West (23.1%; 95% CI, 22.2 - 24.0), followed by the Northeast (26.6%; 95% CI, 25.8 - 27.4), the Midwest (28.4%; 95% CI, 27.8 - 29.0), and the South (30.1%; 95% CI, 29.5 - 30.6). Among individual states, including the District of Columbia, inactivity ranged from a low of 17.9% in Colorado to a high of 38.8% in Arkansas.

Communities can do many things to encourage more seniors to exercise, the authors write. They can place residential areas within walking distance of stores and have safe paths between destinations. They can promote activity in public places such as malls, parks, recreational facilities, and senior centers and can organize activities such as mall-walking programs. And organizations for people with specific chronic disorders can develop and promote exercise programs, such as the Walk With Ease program offered by the Arthritis Foundation.

Given the self-reported nature of the survey, the level of physical inactivity may have been underestimated, the authors note. On the other hand, by excluding work-related exercise, activity may have been underestimated. Other limitations include the inability to generalize to the institutionalized population, the use of complete case analysis to calculate missing data, and response rates as low as 25.1% in certain states, although the data were weighted for nonresponse.

This analysis "helps us better understand and address differences in inactivity among adults 50 years and older," Dr Watson said in a press release about the survey. "More work is needed to make it safer and easier for people of all ages and abilities to be physically active in their communities."

The authors have disclosed no relevant financial relationships.

MMWR Morb Mortal Wkly Rep. 2016;65:954-958. Full text

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