Many middle-aged to older adults do not engage in regular exercise at all, despite its importance for healthy aging. Extensive research grounded in behavioral and social science theories has identified numerous determinants of exercise. However, few studies used an exposure-wide approach, a data-driven exploratory method particularly useful for identifying novel determinants.
Methods: We used data from 13 771 participants in the Health and Retirement Study, a diverse, national panel study of adults aged >50 years in the United States, to evaluate 62 candidate determinants of exercise participation. Candidate predictors were drawn from the following domains: health behaviors, physical health, psychological well-being, psychological distress, social factors, and work. We used Poisson regression with robust error variance to individually regress exercise in the outcome wave (t2: 2014/2016) on baseline candidate predictors (at t1: 2010/2012) controlling for all covariates in the previous wave (t0: 2006/2008).
Results: Some physical health conditions (eg, physical functioning limitations and lung disease), psychological factors (eg, health mastery, purpose in life, and positive affect), and social factors (eg, helping others, religious service attendance, and volunteering) were robustly associated with increased subsequent exercise. Among factors related to psychological distress, perceived constraints stood out as a factor in reducing exercise.
Conclusions: We identified potentially novel exercise determinants, such as helping friends/neighbors/relatives, religious attendance, and volunteering, that have not been captured using a theory-driven approach. Future studies validating these findings experimentally in midlife and older adults are needed.
Keywords: exercise; lagged exposure-wide analysis; midlife; physical activity.
Regular exercise is crucial for healthy aging, yet many older adults remain inactive. This study explored factors influencing exercise participation in adults over 50 using data from a large national survey. Researchers examined 62 potential predictors across health, psychological, and social domains. Physical health issues such as lung and heart diseases were strongly associated with not exercising. Unexpectedly, social activities such as helping others, church attendance, and volunteering were the strongest predictors of exercise participation. Similarly, psychological well-being factors such as having a sense of purpose and positive emotions were linked to increased exercise. Many of these strong predictors are not typically considered in traditional behavioral and social science theories, making these findings novel. The study also confirmed the widely accepted view among behavioral scientists that exercise behavior is influenced by numerous factors, each with modest effects. While these results suggest potential targets for interventions to promote exercise, further experimental studies are needed to confirm cause-and-effect relationships. Understanding these diverse influences on exercise behavior could lead to more effective strategies for encouraging physical activity in aging populations, ultimately contributing to better health outcomes for older adults.
© The Author(s) 2025. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.