Physical activity and subjective cognitive decline among U.S. older adults: A population-based analysis of the 2023 behavioral risk factor surveillance system.

Hao, Gary; Guenzel, Nicolas; Michaud, Tzeyu L · Prev Med · 2026

cross_sectional · Level IV

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Abstract

This study sought to assess associations between physical activities and subjective cognitive decline (SCD) among older adults aged 65 years and above. Data were drawn from the 2023 Behavioral Risk Factor Surveillance System and included older adults who completed the cognitive decline module. Multivariable regression models were performed to assess the relationship between self-reported physical activity levels and SCD. We further conducted stratified analyses of 11 types of primary physical activity. Among 73,339 older adults, 33.1 % reported no physical activity, 14.7 % reported insufficient physical activity, 28.4 % met one guideline only, and 23.8 % met both guidelines. Walking (39.7 %), gardening or yard work (8.6 %), and bicycling (2.7 %) were the most commonly reported primary physical activities. As compared to those without physical activities, older adults who engaged in physical activity and met guidelines were less likely to report SCD (only one guideline, Adjusted Prevalence Ratio[95 % CI] = 0.87[0.78, 0.96]; both guidelines, APR[95 % CI] = 0.81[0.73, 0.90]). Participation in certain primary activity types, combined with meeting at least one physical activity guideline, was associated with lower odds of SCD. Our findings highlight the importance of meeting physical activity guidelines to mitigate the risk of SCD among older adults and reveal varying effects by primary activity types.

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