{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:43:05Z","timestamp":1792082585952,"version":"4.4.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Older adults in rural settings often show overlapping cardiovascular, renal, and metabolic abnormalities, yet the meaning of routine-recorded physical activity in health-examination data remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association between routine-recorded physical activity and screening-defined cardio-renal-metabolic (CRM) vulnerability amongst older adults in Wangkui County, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This community-based cross-sectional study used data from the 2025 annual health examination programme for adults aged \u226565\u202fyears. Physical activity was derived from a routine health-examination item and treated as a coarse activity-status indicator, not as a validated measure of exercise dose, intensity, energy expenditure, or activity domain. The primary exposure was inactive versus active; the three-category classification was retained for secondary analysis. The primary outcome was high screening-defined CRM vulnerability, defined as involvement of at least two cardiovascular, metabolic, and broad renal\u2013urinary domains; this was an operational screening construct, not a clinically validated disease phenotype. Modified Poisson regression with robust standard errors estimated prevalence ratios (PRs), with multiple imputation for primary analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Amongst participants with non-missing activity data, 852 were inactive and 1,363 were active. In the fully adjusted multiply imputed model, active routine-recorded activity was associated with higher prevalence of high CRM vulnerability than inactivity (PR\u202f=\u202f1.121, 95% CI: 1.051\u20131.197). Similar patterns were observed for severe and subclinical high CRM vulnerability. Domain-specific analyses showed that the positive pattern was observed mainly for cardiovascular burden and broad renal\u2013urinary screening signals, whereas metabolic and stricter renal indicators were weaker or less consistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Being recorded as active in the routine health-examination activity item co-occurred with greater screening-defined CRM vulnerability. This finding should be interpreted as a context-sensitive screening association, not evidence that physical activity causes CRM vulnerability or that structured physical activity is harmful. The renal\u2013urinary signal should be interpreted conservatively because UACR was unavailable and the broader renal\u2013urinary pattern was observed primarily in relation to urine occult blood positivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1831345","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:10:37Z","timestamp":1783422637000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Routine-recorded physical activity and screening-defined cardio-renal-metabolic vulnerability amongst older adults in a cold-climate agricultural county in Northeast China"],"prefix":"10.3389","volume":"14","author":[{"given":"Zhuangzhuang","family":"Guo","sequence":"first","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]},{"name":"Graduate School, Kyungil University","place":["Gyeongsan-si, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaru","family":"Zhong","sequence":"additional","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongheng","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]},{"name":"Graduate School, Kyungil University","place":["Gyeongsan-si, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng","family":"Xi","sequence":"additional","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaixia","family":"Hou","sequence":"additional","affiliation":[{"name":"School of Wushu, Henan University","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limeng","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Physical Education and Health Science, Mudanjiang Normal University","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dehui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Dongcheng Community Health Service Center, Wangkui County","place":["Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1038\/s41572-022-00376-4","article-title":"Multimorbidity","volume":"8","author":"Skou","year":"2022","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.arr.2011.03.003","article-title":"Aging with multimorbidity: a systematic review of the 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