# Exercising alone in men and group exercise in women are cross-sectionally associated with positive mental health among older Japanese

## TL;DR

Older Japanese men benefit mentally from solo exercise, while women benefit from group exercise, according to a study linking exercise patterns to mental health.

## Contribution

The study reveals gender-specific associations between exercise patterns and mental health in older adults.

## Key findings

- Men who exercise alone show better mental health with more frequent exercise.
- Women who exercise in groups show better mental health with consistent participation.
- All exercise patterns are linked to better physical health across genders.

## Abstract

Although previous studies have reported that exercising with others has a more beneficial effect on the health of older adults than exercising alone, gender differences in the association between exercise patterns and health are unknown. We investigated the cross-sectional association between exercise patterns and physical and mental health by gender.

We analyzed 4,211 men and 4,944 women aged ≥65 years without disabilities. Physical and mental health was assessed using the SF-8 Health Survey. Exercise patterns were measured based on three types: participation in exercise groups, non-group-based exercise with others, and exercising alone. Each exercise pattern was classified into five groups according to frequency and continuity: maintained frequent (i.e., daily or weekly), increase in frequency, maintained moderate (i.e., monthly or yearly), decrease in frequency, and continuing non-exercise. Modified Poisson regression with generalized estimating equations was used to estimate adjusted prevalence ratio (APR) for poor physical/mental health. Covariates included age, marital status, education, economic status, body mass index, chronic medical conditions, smoking, dietary variety, cognition, working status, and social participation.

For physical health, among both genders, all exercise patterns had a significant dose-response relationship between lower levels of exercise frequency and continuity and a higher prevalence of poor physical health, after adjustment for covariates and mutual adjustment for other exercise patterns (all P for trend <0.036). For mental health, among men, only exercising alone had a significant dose-response relationship (P for trend <0.001) [APR: 1.22 (95% CI: 1.07–1.39) for continuing non-exercise, 1.32 (1.11–1.57) for decrease in frequency, compared to maintained frequent]. Among women, the cross-sectional association with mental health was limited to participation in exercise groups (P for trend: 0.006) [APR: 1.24 (95% CI: 1.09–1.40) for continuing non-exercise, 1.26 (1.09–1.47) for decrease in frequency, and 1.37 (1.13–1.66) for maintained moderate, compared to maintained frequent].

All exercise patterns were cross-sectionally associated with physical health across genders. However, mental health outcomes varied: Cross-sectional associations with mental health were observed for men when exercising alone, and for women when exercising in groups. These results highlight the importance of gender-sensitive public health strategies, such as tailored community exercise programs. Due to the cross-sectional design, causality cannot be determined. However, the results do suggest that future longitudinal research is needed.

The online version contains supplementary material available at https://doi.org/10.1265/ehpm.25-00118.