Physical Inactivity and Cardiovascular Health in Aging Populations: Epidemiological Evidence and Policy Implications from Riyadh, Saudi Arabia
Abstract
1. Introduction
1.1. Aim of the Study
1.2. Research Question
- What is the association between physical inactivity and key cardiovascular disease (CVD) risk factors (e.g., hypertension, diabetes, obesity) in older adults in Riyadh?
- What are the demographic and socioeconomic determinants of physical inactivity among older adults in this population?
- How do existing policy recommendations align with the specific barriers to physical activity in Riyadh, and what strategies can be proposed to address these barriers?
2. Materials and Methods
2.1. Study Design
2.2. Setting
2.3. Sample and Sampling
2.4. Inclusion Criteria
- Age: Participants aged 60 years or older were selected to focus on the elderly population, where the risk of cardiovascular diseases and physical inactivity tends to be higher.
- Medical Status: Individuals diagnosed with or at risk for cardiovascular diseases, as determined by their medical records or clinical evaluation, were included to ensure the study’s relevance to cardiovascular health.
- Hospital Attendance: Only patients attending the hospital for routine medical care, follow-ups, or cardiovascular-related issues were considered.
- Consent: Participants were required to provide informed consent. In cases where participants were unable to consent independently (e.g., due to mild cognitive impairment), consent was obtained from their legal guardians or caregivers.
2.5. Exclusion Criteria
- Severe Cognitive or Communication Impairments: Individuals unable to comprehend the study procedures or respond to the questionnaire due to severe cognitive decline, dementia, or language barriers were excluded.
- Terminal Illnesses: Patients with terminal conditions or those receiving palliative care were excluded, as their health status could significantly confound the study results.
- Non-Compliance: Individuals unwilling or unable to complete the questionnaire or participate in anthropometric measurements were excluded.
2.6. Sampling Technique
- Screening: Medical records and patient appointment schedules were reviewed to identify potential participants who met the inclusion criteria.
- Invitation: Eligible individuals were approached in person, and the study objectives and procedures were explained in detail.
- Voluntary Participation: Participation was entirely voluntary, and individuals were given sufficient time to decide whether to join the study.
2.7. Justification for Sample Size
2.8. Data Collection Tools
2.8.1. Structured Questionnaire
- Demographic Information: Questions on age, gender, marital status, education level, occupation (if applicable), and socioeconomic status.
- Lifestyle Factors: Inquiries about dietary habits, smoking history, alcohol consumption, and sleep patterns.
- Medical History: Questions on participants’ past and current medical conditions, particularly related to cardiovascular diseases (e.g., hypertension, hyperlipidemia, diabetes, and prior cardiovascular events such as myocardial infarction or stroke).
- Family History: Information on the prevalence of cardiovascular diseases and related conditions among first-degree relatives.
2.8.2. Physical Activity Scale for the Elderly (PASE)
- Leisure-Time Activities: Walking, swimming, dancing, and other recreational activities.
- Household Activities: Light and heavy housework, gardening, and yard work.
- Occupational Activities: Physical tasks associated with any part-time or volunteer work.
- A pilot test was conducted with 15 older adults in Riyadh to assess comprehension and clarity. Minor adjustments were made in wording to reflect local activities, such as including references to indoor walking in shopping malls—a common alternative to outdoor exercise due to extreme weather conditions.
- Bilingual administration: The PASE was offered in both English and Arabic, with trained research assistants available to clarify questions for participants with literacy challenges.
- Expert review: The adapted questionnaire was reviewed by local geriatric and public health specialists to ensure its relevance to the Saudi Arabian context.
2.8.3. Medical Record Review
- Blood Pressure: Most recent systolic and diastolic blood pressure readings.
- Lipid Profile: Levels of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides.
- Blood Glucose Levels: Fasting blood glucose and HbA1c readings for participants with or without diabetes.
- Body Mass Index (BMI): Pre-recorded height and weight measurements used to calculate BMI.
- Cardiovascular Diagnoses: Documentation of any diagnosed cardiovascular conditions (e.g., coronary artery disease, heart failure, or arrhythmias).
2.8.4. Anthropometric Measurements
- Weight and Height: Measured using a calibrated digital scale and stadiometer, respectively. BMI was calculated as weight in kilograms divided by height in meters squared (kg/m2).
- Waist Circumference: Measured at the midpoint between the lower rib and the iliac crest using a non-stretchable measuring tape. This measurement was used to assess central obesity, a critical risk factor for cardiovascular diseases.
- Hip Circumference: Taken at the widest part of the hips to calculate the waist-to-hip ratio, another indicator of cardiovascular risk.
2.9. Data Collection Procedure
2.10. Recruitment of Participants
2.11. Administration of the Structured Questionnaire
2.12. Assessment of Physical Activity
- Low physical activity: PASE score ≤ 60 (sedentary lifestyle, minimal activity)
- Moderate physical activity: PASE score 61–100 (occasional structured activity, moderate household chores)
- High physical activity: PASE score > 100 (frequent structured exercise, active daily routines)
- Handgrip strength measurement (via a dynamometer)
- Gait speed testing (as a functional mobility indicator)
- Muscle mass estimation (via bioelectrical impedance analysis or DXA scans)
2.13. Anthropometric Measurements Procedure
2.14. Medical Record Review Procedure
2.15. Quality Control Measures
2.16. Data Analysis
2.17. Data Normality
2.18. Path Analysis Details
2.19. Ethical Considerations
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Categories | n (%) |
---|---|---|
Age (years) | 60–64 | 64 (38.1%) |
65–69 | 55 (32.5%) | |
70–74 | 31 (18.4%) | |
≥75 | 18 (11.0%) | |
Gender | Male | 91 (54.2%) |
Female | 77 (45.8%) | |
Education | No formal | 46 (27.3%) |
High school | 71 (42.5%) | |
College | 51 (30.2%) | |
Marital Status | Married | 119 (71.1%) |
Widowed | 49 (28.9%) | |
Employment Status | Retired | 105 (62.5%) |
Employed | 26 (15.3%) | |
Unemployed | 37 (22.2%) | |
Smoking Status | Current | 43 (25.8%) |
Former | 58 (34.7%) | |
Never | 67 (39.5%) | |
Household Income | <10,000 SAR | 79 (47.3%) |
10,000–20,000 SAR | 59 (35.2%) | |
>20,000 SAR | 29 (17.5%) |
Physical Activity Level | n (%) | Mean PASE Score ± SD | Walking Duration (min/day) ± SD | Vigorous Exercise (%) |
---|---|---|---|---|
Low | 87 (51.8%) | 42.7 ± 12.3 | 15.2 ± 7.1 | 12.3 |
Moderate | 49 (29.2%) | 85.4 ± 10.6 | 32.8 ± 10.4 | 34.6 |
High | 32 (19.0%) | 120.3 ± 15.1 | 52.1 ± 12.7 | 58.7 |
Risk Factor | Low Activity (%) | Moderate Activity (%) | High Activity (%) | p-Value |
---|---|---|---|---|
Hypertension | 78.2 | 63.1 | 41.8 | <0.001 |
Diabetes | 64.4 | 49.8 | 28.7 | <0.001 |
Obesity (BMI ≥ 30) | 51.3 | 39.6 | 22.3 | <0.001 |
Hyperlipidemia | 69.0 | 55.3 | 35.4 | <0.001 |
History of Stroke | 12.6 | 8.4 | 4.3 | <0.05 |
Coronary Artery Disease | 28.7 | 18.5 | 9.8 | <0.001 |
Indicator | Low Activity | Moderate Activity | High Activity | p-Value |
---|---|---|---|---|
Systolic BP (mmHg) | 148.7 ± 9.4 | 132.6 ± 8.5 | 125.4 ± 7.2 | <0.001 |
Diastolic BP (mmHg) | 92.3 ± 7.1 | 85.4 ± 6.2 | 80.1 ± 5.6 | <0.001 |
Total Cholesterol (mg/dL) | 236.5 ± 18.3 | 202.4 ± 15.8 | 182.7 ± 12.9 | <0.001 |
HDL Cholesterol (mg/dL) | 38.2 ± 5.1 | 46.7 ± 6.4 | 52.3 ± 7.2 | <0.001 |
LDL Cholesterol (mg/dL) | 157.3 ± 14.8 | 128.9 ± 12.7 | 112.4 ± 10.3 | <0.001 |
Blood Glucose (mg/dL) | 161.7 ± 21.4 | 140.2 ± 18.5 | 121.5 ± 15.3 | <0.001 |
Variable | Adjusted OR (95% CI) | p-Value |
---|---|---|
Physical Inactivity | 1.98 (1.53–2.56) | <0.001 |
Hypertension | 1.73 (1.34–2.23) | <0.001 |
Diabetes | 1.52 (1.21–1.91) | <0.001 |
Obesity | 1.41 (1.12–1.79) | <0.001 |
Smoking | 1.29 (0.98–1.68) | 0.045 |
Model Effect Size | R2 = 0.45 |
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Alodhialah, A.M.; Almutairi, A.A.; Almutairi, M. Physical Inactivity and Cardiovascular Health in Aging Populations: Epidemiological Evidence and Policy Implications from Riyadh, Saudi Arabia. Life 2025, 15, 347. https://doi.org/10.3390/life15030347
Alodhialah AM, Almutairi AA, Almutairi M. Physical Inactivity and Cardiovascular Health in Aging Populations: Epidemiological Evidence and Policy Implications from Riyadh, Saudi Arabia. Life. 2025; 15(3):347. https://doi.org/10.3390/life15030347
Chicago/Turabian StyleAlodhialah, Abdulaziz M., Ashwaq A. Almutairi, and Mohammed Almutairi. 2025. "Physical Inactivity and Cardiovascular Health in Aging Populations: Epidemiological Evidence and Policy Implications from Riyadh, Saudi Arabia" Life 15, no. 3: 347. https://doi.org/10.3390/life15030347
APA StyleAlodhialah, A. M., Almutairi, A. A., & Almutairi, M. (2025). Physical Inactivity and Cardiovascular Health in Aging Populations: Epidemiological Evidence and Policy Implications from Riyadh, Saudi Arabia. Life, 15(3), 347. https://doi.org/10.3390/life15030347