Geriatric Nursing · Nov 5, 2026

The mediating role of self-rated health in the relationship between number of chronic conditions and physical activity among older adults: A cross-sectional study

By Thapa A, Biddle MJ, Ramezani N et al.

Background/objectives Older adults frequently experience numerous chronic conditions, which can negatively impact physical activity. We examined whether self-rated health mediates the relationship between the number of chronic conditions and physical activity among older adults participating in the congregate meal program, a federally supported healthy meal program delivered in community settings. Methods We conducted a secondary cross-sectional analysis of baseline data collected from older adults (N = 389) attending community dining sites in Washington, DC (n = 6) and Eastern Kentucky (n = 6). Physical activity was assessed using the Rapid Assessment of Physical Activity (RAPA), and self-rated health was measured with a single-item Likert scale. The number of chronic conditions was assessed by self-report of 10 commonly occurring chronic health conditions previously diagnosed by a healthcare provider. Mediation analysis was conducted using Hayes’ PROCESS macro, adjusting for age, sex, education, and race. Results A greater number of chronic conditions was associated with lower self-rated health (a = –0.183, p < .001), which was associated with lower physical activity (b = 0.372, p = .004). A significant indirect association between the number of chronic conditions and physical activity through self-rated health was observed (a*b = –0.068; 95% confidence interval [–0.132, –0.018]). Conclusion Among older adults, self-rated health may represent an important explanatory factor in the relationship between the number of chronic conditions and physical activity. Further study with a larger sample and more rigorous study design is indicated.

doi.org/10.1016/j.gerinurse.2026.104421PubMed 42982002Populations