Dynamic interactions between physical activity, exercise adherence, and adverse psychological states in Chinese older adults: a cross-lagged network analysis

Background With the accelerating process of population ageing in China, negative emotional problems in older people have become increasingly prominent. Exploring the dynamic relationship between these emotions and physical activity, as well as exercise adherence, is of great significance for promoting the physical and mental health of older people. Methods This study used a longitudinal design to conduct two follow-up surveys of 876 older adult individuals in China. A cross-lagged network analysis method was employed to examine the interactions between physical activity, exercise adherence, and adverse psychological states indicators (depression, anxiety, stress, loneliness, and sadness/anger rumination). Results Cross-sectional network analysis showed that physical activity and exercise adherence maintained a stable relationship, and the network structure tended to become more concentrated over time. The cross-lagged analysis found that exercise adherence not only showed good temporal stability ( β = 0.233) but also significantly predicted subsequent levels of physical activity ( β = 0.131) and had a negative predictive effect on stress ( β = −0.129), anxiety ( β = −0.081), and loneliness ( β = −0.079). At the same time, adverse psychological states formed a mutually reinforcing network structure, with stress and anxiety having higher centrality in the system. Conclusion Exercise adherence plays a key role in the physical and mental health of the older adult in China, serving as an important bridge between physical activity and psychological wellbeing. The findings provide an important basis for developing targeted health promotion programs for older people, suggesting that emphasis should be placed on the formation and maintenance of exercise habits, with phased and multi-level intervention strategies.