Frontiers in public health · 2026
The dynamic association between physical exercise and depressive symptoms in China: an age-period-cohort analysis using the HAPC-CCREM and the moderating role of urban-rural disparities.
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Yu Fuxiang, Niu Long, He Boyang, Zhang Ningyi, Guo Ce
Аннотация
BACKGROUND: While the positive association between physical exercise and depressive symptoms (as an indicator of mental health) is well-established, existing research lacks a dynamic life-course and socio-generational perspective. It remains unclear how these associations evolve across different ages, historical periods, and birth cohorts, and how they are moderated by structural factors such as the urban-rural divide.
METHODS: Utilizing pooled cross-sectional data from five waves (2010-2017) of the China General Social Survey (CGSS) with 28,618 valid adult samples, this study employs a Hierarchical Age-Period-Cohort Cross-Classified Random Effects Model (HAPC-CCREM) to disentangle age, period, and cohort patterns.
RESULTS: The advantage associated with regular physical exercise in terms of depressive symptoms exhibits a non-linear age pattern suggestive of a U-shape, being strongest among younger and older adults but attenuated during middle age. Cohort analysis reveals that earlier-born cohorts show a stronger positive association between exercise and fewer depressive symptoms. This positive association declined with socio-economic development but shows a resurgence among the post-1990s cohort, suggesting possible links to socio-economic development and shifting values. Urban-rural disparities significantly moderate this association: urban residents exhibit a stronger positive association and more effective stress-alleviating patterns from exercise, whereas the corresponding association for rural residents is comparatively limited.
CONCLUSION: The positive psychological correlates of physical exercise with respect to depressive symptoms are not static but are dynamically shaped by individual life stages and macro-social transformations. In the context of China's transition towards post-materialist values, the role of exercise may be shifting from a "luxury enhancer" to a "necessary support." Future public health strategies should adopt a differentiated approach, considering life-course stages, cohort experiences, and urban-rural structural contexts to implement precise mental health promotion strategies (i.e., reducing depressive symptoms).
METHODS: Utilizing pooled cross-sectional data from five waves (2010-2017) of the China General Social Survey (CGSS) with 28,618 valid adult samples, this study employs a Hierarchical Age-Period-Cohort Cross-Classified Random Effects Model (HAPC-CCREM) to disentangle age, period, and cohort patterns.
RESULTS: The advantage associated with regular physical exercise in terms of depressive symptoms exhibits a non-linear age pattern suggestive of a U-shape, being strongest among younger and older adults but attenuated during middle age. Cohort analysis reveals that earlier-born cohorts show a stronger positive association between exercise and fewer depressive symptoms. This positive association declined with socio-economic development but shows a resurgence among the post-1990s cohort, suggesting possible links to socio-economic development and shifting values. Urban-rural disparities significantly moderate this association: urban residents exhibit a stronger positive association and more effective stress-alleviating patterns from exercise, whereas the corresponding association for rural residents is comparatively limited.
CONCLUSION: The positive psychological correlates of physical exercise with respect to depressive symptoms are not static but are dynamically shaped by individual life stages and macro-social transformations. In the context of China's transition towards post-materialist values, the role of exercise may be shifting from a "luxury enhancer" to a "necessary support." Future public health strategies should adopt a differentiated approach, considering life-course stages, cohort experiences, and urban-rural structural contexts to implement precise mental health promotion strategies (i.e., reducing depressive symptoms).