Adherence to 24-Hour Movement Guidelines Among ChineseOlder Adults:Prevalence, Correlates, and Associations WithPhysical and Mental Health Outcomes

Background: It is known that 24-hour movement behaviors, including physical activity (PA), sedentary behavior (SB), andsleep, are crucial components affecting older adults'health. Canadian 24-hour movement guidelines for older adults were launchedin 2020, emphasizing the combined role of these 3 movement behaviors in promoting older adults'health. However, research onthe prevalence and correlates of guideline adherence and its associations with health-related outcomes is limited, especially amongChinese older adults. Objective: This study aimed to investigate the prevalence and correlates of meeting 24-hour movement guidelines amongChinese older adults. Furthermore, this study aimed to examine the associations of guideline adherence with older adults'physicaland mental health outcomes. Methods: Using a stratified cluster random sampling approach, a total of 4562 older adults (mean age 67.68 years, SD 5.03years; female proportion: 2544/4562, 55.8%) were recruited from the latest provincial health surveillance of Hubei China fromJuly 25 to November 19, 2020. Measures included demographics, movement behaviors (PA, SB, and sleep), BMI, waistcircumference, waist-hip ratio (WHR), percentage body fat (PBF), systolic and diastolic blood pressure, physical fitness, depressivesymptoms, and loneliness. Generalized linear mixed models were employed to examine the associations between variables usingSPSS 28.0 (IBM Corp). Results: Only 1.8% (83/4562) of participants met all 3 movement guidelines, while 32.1% (1466/4562), 3.4% (155/4562), and66.4% (3031/4562) met the individual behavioral guidelines for PA, SB, and sleep, respectively. Participants who were older,were female, and lived in municipalities with lower economic levels were less likely to meet all 3 movement guidelines. Adheringto individual or combined movement guidelines was associated with greater physical fitness and lower values of BMI, waistcircumference, WHR, PBF, depressive symptoms, and loneliness, with the exception of the relationship of SB+sleep guidelineswith loneliness. Furthermore, only meeting SB guidelines or meeting both PA and SB guidelines was associated with lowersystolic blood pressure