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Background <p>Rapid population ageing poses major challenges for health systems, particularly in middle-income countries such as Iran. Healthy ageing, as defined by the World Health Organization, emphasizes maintaining functional ability and well-being rather than the absence of disease. Physical activity is a key modifiable determinant of healthy ageing; however, evidence remains limited among older adults with chronic conditions and functional vulnerability. Therefore, this study aimed to examine the association between physical activity and healthy ageing among older adults with chronic conditions and/or functional vulnerability in Iran.</p> Methods <p>This descriptive–analytical cross-sectional study was conducted between August and October 2025 among older adults aged ≥ 60 years attending a public hospital and affiliated outpatient/rehabilitation clinics in Qazvin Province, Iran. Participants were selected using simple random sampling. Eligibility was based on age, ability to communicate, informed consent, and evidence of chronic disease and/or functional vulnerability identified through clinical history, participant report, and screening at recruitment. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Healthy ageing was measured using the Healthy Ageing Questionnaire (HAQ) Index, and perspectives on healthy ageing were assessed using the Healthy Aging Perspectives Questionnaire (HAPQ). Associations were examined using correlation analyses, group comparisons, and multivariable linear regression models adjusting for sociodemographic and health-related covariates.</p> Results <p>Among 190 participants (mean age 68.0 ± 7.3 years; 57.4% women), 74.4% had low physical activity. Total physical activity was positively correlated with healthy ageing (HAQ total score: ρ = 0.42, <i>p</i> &lt; 0.001) and healthy ageing perspectives (HAPQ total score: ρ = 0.28, <i>p</i> &lt; 0.001). In adjusted linear regression models, each 100 MET-min/week increase in physical activity was associated with a 0.85-point higher HAQ score (95% CI 0.35–1.35; <i>p</i> = 0.001) and a 0.018-point higher HAPQ score (95% CI 0.006–0.030; <i>p</i> = 0.003). Compared with low physical activity, high physical activity was associated with higher HAQ scores (β = 10.8, 95% CI 5.0–16.6; <i>p</i> &lt; 0.001) and higher HAPQ scores (β = 0.21, 95% CI 0.07–0.35; <i>p</i> = 0.004), indicating a dose–response pattern. Associations were strongest for physical functioning/activity participation, socio-occupational functioning, lifestyle change, and social relationship change.</p> Conclusion <p>Higher levels of physical activity are independently associated with better multidimensional healthy ageing and more positive perspectives on ageing among older adults with chronic conditions and functional vulnerability. These findings highlight physical activity as a key modifiable factor for promoting healthy ageing and support the integration of feasible physical activity interventions into health-care and rehabilitation services for older adults, particularly in rapidly ageing middle-income settings.</p>

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Physical activity and healthy ageing among older adults with chronic conditions: a cross-sectional study of functional ability and ageing perspectives

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月28日

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  • Sima Rafiei,
  • Saber Souri,
  • Mohammad Amerzadeh

摘要

Background

Rapid population ageing poses major challenges for health systems, particularly in middle-income countries such as Iran. Healthy ageing, as defined by the World Health Organization, emphasizes maintaining functional ability and well-being rather than the absence of disease. Physical activity is a key modifiable determinant of healthy ageing; however, evidence remains limited among older adults with chronic conditions and functional vulnerability. Therefore, this study aimed to examine the association between physical activity and healthy ageing among older adults with chronic conditions and/or functional vulnerability in Iran.

Methods

This descriptive–analytical cross-sectional study was conducted between August and October 2025 among older adults aged ≥ 60 years attending a public hospital and affiliated outpatient/rehabilitation clinics in Qazvin Province, Iran. Participants were selected using simple random sampling. Eligibility was based on age, ability to communicate, informed consent, and evidence of chronic disease and/or functional vulnerability identified through clinical history, participant report, and screening at recruitment. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). Healthy ageing was measured using the Healthy Ageing Questionnaire (HAQ) Index, and perspectives on healthy ageing were assessed using the Healthy Aging Perspectives Questionnaire (HAPQ). Associations were examined using correlation analyses, group comparisons, and multivariable linear regression models adjusting for sociodemographic and health-related covariates.

Results

Among 190 participants (mean age 68.0 ± 7.3 years; 57.4% women), 74.4% had low physical activity. Total physical activity was positively correlated with healthy ageing (HAQ total score: ρ = 0.42, p < 0.001) and healthy ageing perspectives (HAPQ total score: ρ = 0.28, p < 0.001). In adjusted linear regression models, each 100 MET-min/week increase in physical activity was associated with a 0.85-point higher HAQ score (95% CI 0.35–1.35; p = 0.001) and a 0.018-point higher HAPQ score (95% CI 0.006–0.030; p = 0.003). Compared with low physical activity, high physical activity was associated with higher HAQ scores (β = 10.8, 95% CI 5.0–16.6; p < 0.001) and higher HAPQ scores (β = 0.21, 95% CI 0.07–0.35; p = 0.004), indicating a dose–response pattern. Associations were strongest for physical functioning/activity participation, socio-occupational functioning, lifestyle change, and social relationship change.

Conclusion

Higher levels of physical activity are independently associated with better multidimensional healthy ageing and more positive perspectives on ageing among older adults with chronic conditions and functional vulnerability. These findings highlight physical activity as a key modifiable factor for promoting healthy ageing and support the integration of feasible physical activity interventions into health-care and rehabilitation services for older adults, particularly in rapidly ageing middle-income settings.