Insights Into Life-Course Trends In Physical Activity: The CARDIA Study

PURPOSE: Physical activity (PA) is vital for healthy aging, playing a key role in preserving cardiovascular health, mobility, and mitigating chronic disease risk. Yet, engagement in PA, especially higher intensity exercise, often declines with aging. Despite its importance, patterns of decline across diverse populations are not well understood. This study aims to examine changes in PA from early adulthood to midlife, examining trends by activity type across domains and intensity category. METHODS: Data are from 5,114 (n = 5,115; n = 1 withdrew) Coronary Artery Risk Development in Young Adults (CARDIA) participants [58% female, 55% Black, aged 24.8 ± 3.7 years (baseline; 1985-86)] who attended at least one exam across exams 1-10 (average: 7.4 exams attended). Participation in PA within 13 category prompts was measured by the CARDIA Physical Activity History (PAH) questionnaire at each exam. Participant data were grouped based on ages (5-year age increments from <25 to ≥65 years). Across each PA category, participants reporting no participation over the past 12 months were determined as non-participants in the respective PA category. Findings are presented as heat maps. RESULTS: Leisure-time walking is the most commonly reported activity type, maintaining high participation rates (>75%) into midlife (Figure). Similarly, home-based activities show consistent engagement, with less decline compared to other types of activities. In contrast, participation in higher-intensity activities such as jogging/running, swimming, and racket sports, as well as structured group activities and vigorous sports, declines with age. CONCLUSIONS: Leisure-time walking remains a prevalent and stable form of PA as individuals age, while higher intensity activities and structured group exercises decline with age. Emphasizing walking in interventions, which demonstrated sustained high engagement, may offer an effective strategy for promoting PA supporting healthy aging. Supported by: The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by contracts 75N92023D00002, 75N92023D00003, 75N92023D00004, 75N92023D00005, and 75N92023D00006 from the National Heart, Lung, and Blood Institute (NHLBI).