Physical Inactivity - Age 65+ in United States

United States

Physical inactivity, or living a sedentary lifestyle, can increase the risk of negative health outcomes such as cardiovascular disease, cancer and cancer mortality, Type 2 diabetes and premature death. Increasing physical activity, meanwhile, has been found to reduce mortality from all causes and can prevent or delay the onset of many chronic diseases. 

Older adults tend to be more sedentary than younger people, increasing their susceptibility to diseases associated with physical inactivity. Older adults should aim to engage in the recommended 150 minutes per week of moderate-intensity aerobic activity—or as much as they can safely do within their physical limitations, taking into account any chronic conditions or disabilities and adjusting as needed. Around 10% of deaths among adults ages 40-69 and 8% of deaths among adults age 70 and older can be attributed to physical inactivity.

According to America’s Health Rankings analysis, the prevalence of physical inactivity is higher among:

• Older women compared with older men.
• Hispanic and Black older adults compared with Hawaiian/Pacific Islander and Asian older adults.
• Older adults with less than a high school education, who have a prevalence more than two times that of college graduates; the prevalence is lower with each increase in education level. 
• Older adults with an annual household income less than $25,000, who have a prevalence three times that of those making $150,000 or more annually; the prevalence is lower with each increase in income level. 
• Older adults living in nonmetropolitan areas compared with those in metropolitan areas.
• Older adults who have difficulty with self-care compared with those without a disability.

The Centers for Disease Control and Prevention recommends that adults age 65 and older incorporate at least 150 minutes of moderate-intensity aerobic activity into their weekly routines (e.g., 30 minutes a day, five days each week). Evidence-based programs recommended by the National Council on Aging include EnhanceFitness and Healthy Moves for Aging Well. Additionally, the council’s Active Choices program offers tailored programming for older adults in the comfort of their own homes.

At the organizational level, strategies to increase physical activity may involve investing in the built environment. For example, increasing neighborhood walkability can promote healthy weight and active lifestyles in a community. Neighborhood walkability can be assessed and improved using the Active Communities tool. Other cost-effective approaches recommended by the Community Preventive Services Task Force focus on enhancing access to parks, trails and greenways, as well as increasing structured programming and community engagement.

Healthy People 2030 has several goals related to physical activity, including reducing the proportion of adults who do no physical activity in their free time and increasing the proportion of older adults with physical or cognitive health problems who get physical activity.

Carlson, Susan A., E. Kathleen Adams, Zhou Yang, and Janet E. Fulton. “Percentage of Deaths Associated With Inadequate Physical Activity in the United States.” Preventing Chronic Disease 15 (March 29, 2018): 170354. https://doi.org/10.5888/pcd18.170354.

de Rezende, Leandro Fornias Machado, Juan Pablo Rey-López, Victor Keihan Rodrigues Matsudo, and Olinda do Carmo Luiz. “Sedentary Behavior and Health Outcomes among Older Adults: A Systematic Review.” BMC Public Health 14, no. 1 (December 2014): 333. https://doi.org/10.1186/1471-2458-14-333.

Friedenreich, Christine M., Charlotte Ryder-Burbidge, and Jessica McNeil. “Physical Activity, Obesity and Sedentary Behavior in Cancer Etiology: Epidemiologic Evidence and Biologic Mechanisms.” Molecular Oncology 15, no. 3 (March 2021): 790–800. https://doi.org/10.1002/1878-0261.12772.

Gilchrist, Susan C., Virginia J. Howard, Tomi Akinyemiju, Suzanne E. Judd, Mary Cushman, Steven P. Hooker, and Keith M. Diaz. “Association of Sedentary Behavior With Cancer Mortality in Middle-Aged and Older US Adults.” JAMA Oncology 6, no. 8 (June 18, 2020): 1210–17. https://doi.org/10.1001/jamaoncol.2020.2045.

Hupin, David, Frédéric Roche, Vincent Gremeaux, Jean-Claude Chatard, Mathieu Oriol, Jean-Michel Gaspoz, Jean-Claude Barthélémy, and Pascal Edouard. “Even a Low-Dose of Moderate-to-Vigorous Physical Activity Reduces Mortality by 22% in Adults Aged =60 Years: A Systematic Review and Meta-Analysis.” British Journal of Sports Medicine 49, no. 19 (October 1, 2015): 1262–67. https://doi.org/10.1136/bjsports-2014-094306.

Kim, Yeonju, Lynne R. Wilkens, Song-Yi Park, Marc T. Goodman, Kristine R. Monroe, and Laurence N. Kolonel. “Association between Various Sedentary Behaviours and All-Cause, Cardiovascular Disease and Cancer Mortality: The Multiethnic Cohort Study.” International Journal of Epidemiology 42, no. 4 (August 2013): 1040–56. https://doi.org/10.1093/ije/dyt108.

U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd Edition. Washington, D.C.: U.S. Department of Health and Human Services, 2018. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf.

Wang, Monica L., Marie-Rachelle Narcisse, and Pearl A. McElfish. “Higher Walkability Associated with Increased Physical Activity and Reduced Obesity among United States Adults.” Obesity 31, no. 2 (February 2023): 553–64. https://doi.org/10.1002/oby.23634.