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The present study investigated the associations between physical activity (i.e., sedentary behavior and moderate\u2010to\u2010vigorous activity) assessed via accelerometer across 7\u2009days and caregiver\u2010reported physical and mental health of 66 nondemented middle\u2010aged adults with Down syndrome aged 25\u201355\u2009years (52% female). Regression analyses indicated that more time spent in moderate intensity physical activity was associated with less risk of sleep apnea (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22120.031, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004) and endocrine\/metabolic conditions (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22120.046, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.009), and lower total number of physical health conditions (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22120.110, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.016) and anxiety disorders (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22120.021, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.049) after controlling for relevant sociodemographics. After also adjusting for body\u2010mass\u2010index (BMI), the association between time spent in moderate intensity physical activity and sleep apnea (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22120.035, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002), endocrine\/metabolic conditions (<jats:italic>\u03b2<\/jats:italic> = \u22120.033, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.045) and total physical health (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22120.091, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.026) remained significant. Unexpectedly, time spent in sedentary behavior was negatively associated with musculoskeletal conditions (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22120.017, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.044). Findings indicate important associations between physical activity in everyday life and the physical and mental health of adults with Down syndrome. Social policies and interventions aimed at reducing time spent sitting around (i.e., sedentary behavior) and encouraging moderate\u2010to\u2010vigorous activity may be a low\u2010burden and low\u2010cost mechanism for fostering healthy physical and mental aging in the Down syndrome population.<\/jats:p>","DOI":"10.1111\/jppi.12434","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T04:18:36Z","timestamp":1656735516000},"page":"408-418","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Physical activity and physical and mental health in <scp>middle\u2010aged<\/scp> adults with Down syndrome"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6788-294X","authenticated-orcid":false,"given":"Victoria","family":"Fleming","sequence":"first","affiliation":[{"name":"Waisman Center University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"School of Human Ecology University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Piro\u2010Gambetti","sequence":"additional","affiliation":[{"name":"Waisman Center University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"School of Human Ecology University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Handen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley T.","family":"Christian","sequence":"additional","affiliation":[{"name":"Waisman Center University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Department of Psychiatry University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Tudorascu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"Plante","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozioma","family":"Okonkwo","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigan 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