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Dose–response relationships between physical activity, walking and health-related quality of life in mid-age and older women
  1. Kristiann C Heesch1,
  2. Jannique G Z van Uffelen2,3,
  3. Yolanda R van Gellecum2,
  4. Wendy J Brown2
  1. 1Institute of Health & Biomedical Innovation and the School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
  2. 2School of Human Movement Studies, University of Queensland, Brisbane, Australia
  3. 3Primary Care Research Unit, School of Primary Health Care, Monash University, Notting Hill, Victoria, Australia
  1. Correspondence to Dr Kristiann C Heesch, Queensland University of Technology, School of Public Health and Social Work, Brisbane, Queensland 4059, Australia; k.heesch{at}


Background Although physical activity is associated with health-related quality of life (HRQL), the nature of the dose–response relationship remains unclear.

Objectives To examine the concurrent and prospective dose–response relationships between total physical activity (TPA) and (only) walking with HRQL in two age cohorts of women.

Methods Participants were 10 698 women born in 1946–1951 and 7646 born in 1921–1926, who completed three mailed surveys for the Australian Longitudinal Study on Women's Health. They reported weekly TPA minutes (sum of walking, moderate and vigorous minutes). HRQL was measured with the Medical Outcomes Study Short-Form 36 Health Status Survey (SF-36). Linear mixed models, adjusted for socio-demographic and health-related variables, were used to examine associations between TPA level (none, very low, low, intermediate, sufficient, high and very high) and SF-36 scores. For women who reported walking as their only physical activity, associations between walking and SF-36 scores were also examined.

Results Curvilinear trends were observed between TPA and walking with SF-36 scores. Concurrently, HRQL scores increased significantly with increasing TPA and walking, in both cohorts, with increases less marked above sufficient activity levels. Prospectively, associations were attenuated although significant and meaningful improvements in physical functioning and vitality were observed across most TPA and walking categories above the low category.

Conclusion For women in their 50s–80s without clinical depression, greater amounts of TPA are associated with better current and future HRQL, particularly physical functioning and vitality. Even if walking is their only activity, women, particularly those in their 70s–80s, have better HRQL.

  • Cohort studies
  • exercise
  • longitudinal studies
  • quality of life
  • mental health
  • physical activity
  • health promotion
  • public health
  • psychosocial factors

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  • Funding The authors are grateful to the Australian Government Department of Health and Ageing for funding of ALSWH. JvU and YvG were supported by an NHMRC program grant (Sitting Less And Moving More; #569940) at the University of Queensland, School of Human Movement Studies.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Ethics Committees of the Universities of Queensland and Newcastle.

  • Provenance and peer review Not commissioned; externally peer reviewed.