Exercising alone was cross-sectionally associated with positive mental health among older men, while participation in exercise groups was cross-sectionally associated with positive mental health among older women, highlighting the importance of gender-sensitive public health strategies.
Key Findings
Results
All exercise patterns were cross-sectionally associated with physical health in both men and women, showing a significant dose-response relationship between lower exercise frequency/continuity and higher prevalence of poor physical health.
Analysis included 4,211 men and 4,944 women aged ≥65 years without disabilities
All exercise patterns showed significant dose-response relationships for physical health after adjustment for covariates and mutual adjustment for other exercise patterns
All P for trend values for physical health were <0.036 across both genders
Three exercise pattern types examined: participation in exercise groups, non-group-based exercise with others, and exercising alone
Each exercise pattern was classified into five groups: maintained frequent, increase in frequency, maintained moderate, decrease in frequency, and continuing non-exercise
Results
Among men, only exercising alone showed a significant dose-response relationship with mental health.
P for trend <0.001 for exercising alone and mental health in men
APR: 1.22 (95% CI: 1.07–1.39) for continuing non-exercise compared to maintained frequent
APR: 1.32 (95% CI: 1.11–1.57) for decrease in frequency compared to maintained frequent
Neither participation in exercise groups nor non-group-based exercise with others showed a significant dose-response relationship with mental health in men
Modified Poisson regression with generalized estimating equations was used to estimate adjusted prevalence ratios
Results
Among women, only participation in exercise groups showed a significant dose-response relationship with mental health.
P for trend: 0.006 for participation in exercise groups and mental health in women
APR: 1.24 (95% CI: 1.09–1.40) for continuing non-exercise compared to maintained frequent
APR: 1.26 (95% CI: 1.09–1.47) for decrease in frequency compared to maintained frequent
APR: 1.37 (95% CI: 1.13–1.66) for maintained moderate compared to maintained frequent
Non-group-based exercise with others and exercising alone did not show significant dose-response relationships with mental health in women
Results
Mental health outcomes associated with exercise patterns differed by gender, with men benefiting mentally from exercising alone and women benefiting mentally from group exercise participation.
The cross-sectional association with mental health was observed for men when exercising alone and for women when exercising in groups
This gender difference in mental health associations was not observed for physical health outcomes
Results suggest the need for gender-sensitive public health strategies, such as tailored community exercise programs
Covariates included age, marital status, education, economic status, BMI, chronic medical conditions, smoking, dietary variety, cognition, working status, and social participation
Discussion
The study used a cross-sectional design, precluding determination of causality between exercise patterns and health outcomes.
Physical and mental health was assessed using the SF-8 Health Survey
The authors note that due to the cross-sectional design, causality cannot be determined
The authors call for future longitudinal research to clarify causal relationships
Exercise pattern frequency and continuity were categorized into five groups to capture both current frequency and change over time
Tomioka K, Shima M, Saeki K. (2026). Exercising alone in men and group exercise in women are cross-sectionally associated with positive mental health among older Japanese.. Environmental health and preventive medicine. https://doi.org/10.1265/ehpm.25-00118