Abstract
Introduction: Based on data from the China Health and Retirement Longitudinal Study 2020 (CHARLS 2020), we analyzed the effects of physical activity (PA) on chronic diseases and depression symptoms in older adults in urban and rural areas and examined differences by residential location. Methods: A total of 5481 individuals aged 65 years and above were selected from the CHARLS 2020 dataset. Descriptive statistics, chi-square tests, two-way analysis of variance, and Pearson's correlation analysis were used to examine the influence of different intensities of PA on chronic diseases and depression symptoms. According to PA recommendations, PA participants were individuals who engaged in PA two or more times per week, while non-participants engaged in PA fewer than two times per week. Results: Urban and rural older adults showed different patterns in PA participation and its health impacts. Urban residents were more likely to engage in high-intensity PA, which was related to lower prevalence of chronic diseases and fewer depressive symptoms; moderate-intensity PA was also effective in relieving depressive symptoms. In contrast, rural residents primarily participated in low-intensity PA, which had some effect in alleviating depression symptoms but limited impact on chronic diseases. Conclusions: Public health interventions should be tailored to regional differences. In rural areas, the promotion of appropriate PA programs is essential to improve overall health, while urban areas should emphasize mental health strategies, social engagement, and support network development.