Perceived Exercise Barriers and Functional Health Among Older Chinese Women: The Roles of Physical Activity...

Background: Physical Activity Participation is closely associated with functional health among older women, but this participation is often constrained by multiple perceived barriers. The aim of this study was to examine the association between Perceived Exercise Barriers (PEB) and Basic Activities of Daily Living (BADL) among older women in China, investigate the indirect association of Physical Activity Participation (PAP) in this relationship, and examine the moderating role of Community Sports Facility Accessibility (CSFA) in the association between PEB and PAP. Methods: Using data from the 2023 China Longitudinal Aging Social Survey (CLASS), this cross-sectional study included 5027 women aged 60 years and above. Perceived Exercise Barriers were operationalized as the sum of 18 dichotomous barrier indicators. Basic Activities of Daily Living were measured by summing 11 items assessing daily living functions. Physical Activity Participation was calculated by summing scores across three dimensions: exercise frequency, duration per session, and exercise intensity. Community Sports Facility Accessibility was measured according to the number of available types of community sports resources. A conditional indirect association model was estimated using the SPSS PROCESS macro, and confidence intervals were obtained through the bootstrap method (5000 resamples). Results: Perceived Exercise Barriers were significantly and negatively associated with Basic Activities of Daily Living (B = -0.103, p < 0.001) and Physical Activity Participation (B = -0.471, p < 0.001) among older women. Physical Activity Participation showed a significant but relatively small indirect association between Perceived Exercise Barriers and Basic Activities of Daily Living (indirect effect = -0.034, 95% CI -0.044 to -0.024). Furthermore, Community Sports Facility Accessibility significantly moderated the association between Perceived Exercise Barriers and Physical Activity Participation (interaction term B = 0.094, p < 0.001). Higher levels of facility accessibility were associated with a weaker negative association between Perceived Exercise Barriers and Physical Activity Participation, accompanied by a reduced absolute value of the conditional indirect association. Conclusions: This study identified a potential behavioral pathway linking Perceived Exercise Barriers, Physical Activity Participation, and Basic Activities of Daily Living among older women, and demonstrated the conditional role of Community Sports Facility Accessibility in this association. The findings suggest that improving functional health among older women may require attention to individual perceived barriers, behavioral participation, and supportive community environments.