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Physical inactivity, ageing, and the impact on NCD burden in Spain by 2030: Macrosimulation study

Year: 2026

Type: article

Abstract: Background This study examined the association between physical inactivity, body mass index (BMI), and metabolic equivalent of task (MET), and estimated the potential impact of increased physical activity on non-communicable disease (NCD) burden in Spain by 2030. Methods An ecological analysis was conducted using aggregated data from the European Health Interview Survey in Spain, Waves 2 (n = 22,842) and 3 (n = 22,072). Physical inactivity (as a proportion) was modelled using beta regression with a logit link function. Explanatory variables included sex, age group, BMI, MET levels, and calendar year. The WHO Preventable Risk Integrated Model (PRIME) was used to estimate NCD mortality under a counterfactual scenario of a 15% increase in MET-hours/week of moderate-to-vigorous physical activity and a 15% relative reduction in inactivity prevalence. Uncertainty intervals (UI) were derived from 5,000 Monte Carlo simulations. Results Physical inactivity increased markedly in older adults, with lower levels observed in males (β = −0.32, p < 0.001). At the population level, higher BMI was associated with increased physical inactivity (β = 0.16, p < 0.001), while higher MET levels were associated with lower inactivity (β = −0.02, p < 0.001). A slight overall decline in inactivity over time was observed (β = −0.05, p < 0.001). If trends persist, 34.7% of adults are expected to be physically inactive by 2030. Under the counterfactual scenario, this would fall to 29.5%, with average activity levels among active individuals increasing from 60.1 (SD 41.7) to 69.1 (SD 47.9) MET-hours/week. These changes are associated with an estimated 1,859 prevented premature deaths (95% UI: 1,644–2,083), and 9,596 prevented NCD deaths (95% UI: 8,400–10,791), representing 4.9% of total NCD mortality across all ages. Conclusions Physical inactivity disproportionately affects older adults, and increased physical activity at the population level is associated with lower NCD-related mortality. Key messages • Increased physical activity may contribute to lowering the NCD burden. • Promoting population-level increases in physical activity across the life course is important, particularly in ageing populations.

Source: European Journal of Public Health

DOI: 10.1093/eurpub/ckag169.855

Authors: ANA Muhlis, O Varga, N Mahrouseh, G Chamouni, GL Tarek

Institution: University of Debrecen

Language: English

Topic: Physical Activity and Health

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,181