To explore the mental health level of Chinese adults aged 20~79 years and its association with exercise based on the surveillance data.

A cross-sectional study was conducted in a total of 161 901 samples from the Fifth National Physical Fitness Surveillance, including 121 928 adults aged 20-59 years and 39 973 elderly aged 60-79 years. The mental health status was assessed by a comprehensive questionnaire, and the participation in frequency and duration of exercise were investigated. Chi-square test and Logistic regression were applied to test the relationship between exercise and mental health using SPSS 26.0 software.

The rate of depressive symptoms among residents aged 20-79 years in China was 16.6%(26 311/158 518). In the adults aged 20-59 years, the rates of depression and anxiety symptoms were 18.0%(21 465/119 409) and 13.8%(16 435/119 444), respectively, and the proportion of those who often or always felt stressed was 15.3%(18 373/120 444). In the elderly aged 60-79 years, the rate of depression symptoms was 12.4%(4 846/39 109), the proportion of those with loneliness scale scores higher than 25 was 32.8%(12 650/38 525), and 4.0%(1 587/39 395) elderly often or always felt stressed. Compared with the non-exercisers, the risk of depression symptoms in the exercisers was reduced by 20% (β=-0.22, OR=0.80, 95%CI: 0.78-0.82). With increased frequency and intensity of physical exercise, the mental health condition improved significantly. For those who exercised at least 3 days a week and had moderate intensity or above, the detection rate of depression symptoms decreased by 35% (β=-0.39, OR=0.65, 95%CI: 0.63-0.67).The negative associations between exercise and depression were found in different ages, genders and resident subgroups. The risk of anxiety was 6% lower in the adults who participated in physical activity (β=-0.06, OR=0.94, 95%CI: 0.91-0.97) and 15% lower in those who exercised over 3 days per week at moderate-to-vigorous intensity (β=-0.16, OR=0.85, 95%CI: 0.81-0.89). No association between exercise and risk of stress was observed (P>0.05), but the positive effect was also found as exercise frequency and intensity increased. Older adults with exercise had a reduced risk of high loneliness scores by 50% (β=-0.70, OR=0.50, 95%CI: 0.47-0.52) and a 35% lower detection of stress risk (β=-0.43, OR=0.65, 95%CI: 0.59-0.72).

Exercise was significantly and meaningfully associated with self-reported mental health.Exercise can actively and effectively prevent and improve mental health.

Residents; Mental health; Exercise; Adults; Elders; Empirical analysis