Association between physical activity and mortality in postmenopausal women: evidence from NHANES 2007–2018

TL;DR

This study finds that higher physical activity is linked to lower mortality in postmenopausal women, suggesting modest activity can support healthy aging.

Contribution

The study provides new evidence on the mortality benefits of physical activity levels in postmenopausal women using a large U.S. dataset.

Findings

Insufficiently and sufficiently active total physical activity were associated with reduced all-cause, CVD, and non-CVD mortality.

Leisure-time physical activity showed linear inverse associations with mortality outcomes.

Promoting modest physical activity levels may be an effective strategy for healthy aging in postmenopausal women.

Abstract

Whether physical activity (PA) levels relate to mortality in postmenopausal women remains not well understood.

We analyzed 5,880 postmenopausal women from NHANES 2007–2018 (median follow-up:77 months). PA—including total PA (TPA), leisure-time PA (LTPA), and occupational PA (OPA)—was assessed using the Global Physical Activity Questionnaire and expressed as metabolic equivalent of task (MET)-minutes/week. TPA was classified as no, insufficiently active (< 600), or sufficiently active (≥ 600), while LTPA and OPA were classified as no, low (< 600), or high (≥ 600). Weighted proportional hazards Cox models and restricted cubic spline (RCS) analyses examined associations with all-cause, cardiovascular disease (CVD), and non-CVD mortality.

During follow-up, 718 deaths occurred (215 CVD, 503 non-CVD). Compared with no PA, insufficiently and sufficiently active TPA were associated with reduced risks of all-cause, CVD, and non-CVD mortality; both low and high LTPA with reduced risks of all-cause and non-CVD mortality; and low OPA with reduced risks of all-cause and non-CVD mortality. RCS analyses showed linear inverse associations for TPA and non-linear inverse associations for LTPA with all-cause and non-CVD mortality, while OPA showed no significant associations. Tests for trend were significant for TPA in relation to all-cause and non-CVD mortality, and for LTPA across all three outcomes. Sensitivity analyses excluding early deaths yielded similar results.

Higher TPA and LTPA were associated with reduced risks of all-cause and non-CVD mortality among postmenopausal women. Promoting adequate PA, particularly moving from inactivity to modest levels, may be an effective strategy to support healthy aging in this population.

The online version contains supplementary material available at 10.1186/s12905-026-04315-3.

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