Physical activity and health-related quality of life in Korean postmenopausal women with and without chronic diseases: a population-based study using the KNHANES 2016-2020 database

OBJECTIVE: To evaluate the relationship between physical activity (PA) and health-related quality of life (HRQoL) in Korean postmenopausal women and determine whether this relationship differs according to the presence of chronic diseases. METHODS: This population-based, cross-sectional study used data from 7,846 postmenopausal women who participated in the 2016-2020 Korean National Health and Nutrition Examination Survey. PA was assessed using the Global Physical Activity Questionnaire and categorized according to total intensity (low, moderate, and high) and domains (occupational, leisure time, and commuting). The HRQoL was evaluated using the EuroQol 5-dimension index and its five domains. Multivariate logistic regression was used to estimate the odds ratios and 95% CIs for high HRQoL according to the PA levels and domains stratified according to chronic disease status. RESULTS: Higher PA levels were significantly associated with better HRQoL, particularly in women with chronic diseases (moderate PA: odds ratio = 1.35, 95% CI =1.17-1.57). In this group, greater walking time and lower sedentary time were positively associated with HRQoL, whereas occupational PA showed an inverse relationship. Leisure time and commuting PA were positively correlated with HRQoL, whereas no significant associations were observed among healthy women, except in the mobility domain. CONCLUSIONS: Among postmenopausal women, PA, particularly light-to-moderate activities such as walking and active commuting, was associated with higher HRQoL; stronger effects were observed in those with chronic diseases. These findings highlight the importance of promoting feasible and context-appropriate PA and reducing sedentary behaviors in postmenopausal women to improve their overall well-being.