Engagement in Ageless Gym Programs Among Older Adults in Rural Communities: A Retrospective Study on Relationships With Age, Health Conditions, and Proximity to Health Facilities

<b>Background:</b> To investigate the association between community members' participation in Ageless Gym and their age, chronic disease history, lifestyle, and place of residence, and to analyze the related factors that influence their continuous participation in gym activities and physical fitness improvements. <b>Methods:</b> This study was a retrospective intergenerational study in which 1896 people aged 60 or older, who participated in the integrated community screening in Ershui Township, Changhua County, were analyzed, and the dependent variable was the participation in the Ageless Gym (445 people in total, 23.5%). The independent variables were the most recent screening questionnaire, including chronic disease history, health behaviors, age, and distance from the health center. Cox proportional risk regression modeling has been used as a multivariate variance analysis, and all statistical analyses have been conducted using SAS 9.4. <b>Results:</b> The hypotheses were partially supported: (1) People with a history of diabetes and osteoporosis were 1.62 times more likely to participate in ageless fitness than those without disease, respectively. (2) With regard to lifestyle, those who had regular health checks were 1.54 times more likely to participate in Ageless Gym than those who did not. (3) The probability of participating in ageless gyms is 0.69 and 0.42 times higher for people aged 70 to 79 and 80 than for people aged 60 to 69. (4) Elderly people living far from a health center were 0.67 times more likely to participate in Ageless Gym than those living nearby. (5) Comparison between those who are willing to participate and those who have consistently participated in the Ageless Gym revealed that factors that influence consistent participation include exercise habits, chronic diseases, and emphasis on healthy eating. (6) The fitness of people who regularly participate in the gym has improved considerably. <b>Conclusions:</b> This retrospective study provides insights for promoting exercise among the elderly, emphasizing the relationships between participation, age, health conditions, and proximity to health facilities.