Summary: A new longitudinal study shows that maintaining or adopting regular physical activity during midlife meaningfully improves women’s physical health-related quality of life later in life. Analyzing data from over 11,000 participants followed for 15 years, researchers found that women who consistently met World Health Organization (WHO) physical activity guidelines — or who began meeting them by age 55 — had higher physical health scores in older adulthood than peers who remained inactive. The results emphasize the long-term value of sustained physical activity, particularly for preserving physical functioning in later years.
Key Facts:
- The analysis used longitudinal data from the Australian Longitudinal Study on Women’s Health (ALSWH), tracking participants at three-year intervals over 15 years.
- Women who consistently met, or who began meeting, WHO physical activity guidelines by age 55 had significantly better physical health composite scores (PCS) than those who never met the guidelines.
- The study suggests a clear public health message: start or maintain an active lifestyle through midlife — ideally reaching the WHO target of 150 minutes of activity per week by age 55 — to protect physical health into older age.
Source: PLOS
Consistent adherence to physical activity guidelines during middle age is linked to higher health-related quality of life for women, according to a study published May 2 in the open-access journal PLOS Medicine by Binh Nguyen (University of Sydney) and colleagues.
Most previous evidence connecting physical activity and quality of life has come from cross-sectional research or short-term trials. Long-term, repeated-measure studies that can better approximate causal effects are scarce. This new work addresses that gap by examining activity patterns across midlife and their associations with physical and mental health outcomes in later life.
The researchers analyzed responses from 11,336 women born between 1946 and 1951 who were 47–52 years old at the study’s start. Physical activity was self-reported every three years between 1998 and 2016. Participants were grouped according to whether they met the WHO recommendation of at least 150 minutes of moderate-intensity activity per week: consistently meeting the guideline across the exposure period, not meeting the guideline initially but beginning to meet it at ages 55, 60, or 65, or never meeting the guideline during the period.
Health-related quality of life in 2019 (when participants were aged 68–73) was measured using the SF-36 survey, producing two primary outcomes: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Higher scores (0–100 scale) indicate better perceived physical or mental health.
Using a target trial emulation approach to approximate randomized comparisons, and applying marginal structural models to adjust for sociodemographic and health-related confounders, the team found that consistent adherence to guidelines during midlife and first achieving the guidelines by age 55 were both associated with approximately a three-point higher PCS compared with persistent inactivity. These effects remained significant after controlling for socioeconomic factors and pre-existing diagnoses. The study observed similar positive patterns across most SF-36 physical subscales.
No meaningful association was found between patterns of physical activity and the SF-36 mental health composite score (MCS) in this cohort. The authors note that while these findings support long-term physical benefits from midlife activity, they do not rule out other mental health benefits that might be detectable with different measures or in different populations.
The authors acknowledge limitations, including reliance on self-reported activity, potential residual confounding from unmeasured or incompletely measured health conditions, and limits to generalizability beyond this cohort of Australian midlife women.
“Taken together with prior research, our results add to growing evidence that maintaining or adopting an active lifestyle during mid-age offers important long-term benefits for physical health,” the study team concludes. “A core public health message is that being active for as many years as possible — and ideally reaching the WHO activity target by around age 55 — can help preserve physical functioning in later life.”
Funding: The Australian Longitudinal Study on Women’s Health is funded by the Australian Government Department of Health. Additional investigator and fellowship support for authors is acknowledged from the National Health and Medical Research Council and the New South Wales Cardiovascular Research Capacity Program. Funders had no role in study design, data collection and analysis, decision to publish, or manuscript preparation.
Abstract
Competing interests: The authors have declared that no competing interests exist.
Background
There is limited long-term evidence on how patterns of physical activity across midlife affect health-related quality of life later in life. This study examined 15-year activity patterns and their association with both physical and mental health domains among a large cohort of midlife women in Australia.
Methods and findings
Data were collected at three-year intervals from 1998 to 2019 for 11,336 women in the ALSWH 1946–1951 birth cohort. Primary outcomes in 2019 were SF-36 PCS and MCS scores. Using an emulated trial framework, researchers compared (1) consistent adherence to WHO activity guidelines across the exposure period with (2) initiating guideline-level activity at ages 55, 60, or 65, against the reference of consistent non-adherence. Analyses used marginal structural models adjusted for sociodemographic and health covariates. Consistent adherence and first meeting guidelines at age 55 were each associated with a three-point higher PCS than persistent inactivity. No significant effects were observed for MCS. Limitations include potential unmeasured confounding, self-reported activity, and limited generalizability.
Conclusions
The findings suggest that women who remain active throughout midlife — and those who increase activity to meet WHO guidelines by about age 55 — are likely to experience better physical health-related quality of life in later years. These results support policies and programs that promote sustained physical activity across midlife to preserve physical function and well-being as people age.