Frontiers in Public Health · Mar 5, 2026

Traditional physical exercise and depression in older adults: the mediating role of interoceptive awareness and the moderating effect of perceived stress

By Zheng Y, Lin Y, Zheng Q

OBJECTIVE: This study examined the associations between traditional physical exercise and depressive symptoms among older adults, with particular attention to the mediating role of interoceptive awareness and the moderating effect of perceived stress. METHODS: A cross-sectional survey was conducted with 337 older adults who regularly participated in traditional physical exercise. Measures included the Physical Activity Rating Scale (PARS-3), the Multidimensional Assessment of Interoceptive Awareness (MAIA-2), the Perceived Stress Scale (PSS), and the Patient Health Questionnaire-9 (PHQ-9). Confirmatory factor analysis and model fit indices were examined using AMOS. Mediation and moderation analyses were conducted using SPSS, with bias-corrected bootstrap confidence intervals based on 5,000 resamples. RESULTS: Traditional physical exercise showed a significant association with lower depressive symptoms. Interoceptive awareness partially explained this association, suggesting that greater awareness of internal bodily states may represent one pathway linking exercise participation and mental health. Perceived stress moderated the relationship between traditional physical exercise and interoceptive awareness, with higher stress levels attenuating this association. CONCLUSION: Traditional physical exercise was associated with lower depressive symptoms, and this association was partly accounted for by interoceptive awareness. In addition, perceived stress moderated the strength of the exercise-interoceptive awareness association.

doi.org/10.3389/fpubh.2026.1766902 Open access PubMed 41869607 Populations