Age-Dependent Heterogeneity in the Association Between Physical Activity and Mental Distress: A Causal Machine Learning Analysis of 3.2 Million U.S. Adults

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1. Verfasser: Shan, Yuan
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Veröffentlicht: 2026
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author Shan, Yuan
author_facet Shan, Yuan
contents Physical activity (PA) is widely recognized as protective against mental distress, yet whether this benefit varies systematically across population subgroups remains poorly understood. Using pooled data from ten consecutive annual waves of the U.S. Behavioral Risk Factor Surveillance System (2015-2024; n = 3,242,218), we investigate heterogeneity in the association between leisure-time PA and frequent mental distress (FMD, >=14 days/month) across age groups. Survey-weighted logistic regression reveals a striking age gradient: the adjusted odds ratio for PA ranges from 0.89 among young adults (18-24) to 0.50 among adults aged 55-64, with the protective association strengthening monotonically with age. Temporal analysis across all ten years shows that the young-adult PA effect has been eroding over the past decade, with the 18-24 OR reaching 1.01 (null) in both 2018 and 2024 -- paralleling the deepening youth mental health crisis. Causal Forest via Double Machine Learning independently identifies age as the dominant driver of treatment effect heterogeneity (feature importance = 0.39, 2.5x the next predictor). E-value sensitivity analysis, propensity score overlap checks, placebo tests, and imputation comparisons confirm the robustness of the findings. These results suggest that the well-documented exercise--mental health link may not generalize to the youngest adult population, whose distress appears increasingly driven by stressors that PA alone cannot mitigate.
format Preprint
id arxiv_https___arxiv_org_abs_2604_19066
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Age-Dependent Heterogeneity in the Association Between Physical Activity and Mental Distress: A Causal Machine Learning Analysis of 3.2 Million U.S. Adults
Shan, Yuan
Machine Learning
Applications
Physical activity (PA) is widely recognized as protective against mental distress, yet whether this benefit varies systematically across population subgroups remains poorly understood. Using pooled data from ten consecutive annual waves of the U.S. Behavioral Risk Factor Surveillance System (2015-2024; n = 3,242,218), we investigate heterogeneity in the association between leisure-time PA and frequent mental distress (FMD, >=14 days/month) across age groups. Survey-weighted logistic regression reveals a striking age gradient: the adjusted odds ratio for PA ranges from 0.89 among young adults (18-24) to 0.50 among adults aged 55-64, with the protective association strengthening monotonically with age. Temporal analysis across all ten years shows that the young-adult PA effect has been eroding over the past decade, with the 18-24 OR reaching 1.01 (null) in both 2018 and 2024 -- paralleling the deepening youth mental health crisis. Causal Forest via Double Machine Learning independently identifies age as the dominant driver of treatment effect heterogeneity (feature importance = 0.39, 2.5x the next predictor). E-value sensitivity analysis, propensity score overlap checks, placebo tests, and imputation comparisons confirm the robustness of the findings. These results suggest that the well-documented exercise--mental health link may not generalize to the youngest adult population, whose distress appears increasingly driven by stressors that PA alone cannot mitigate.
title Age-Dependent Heterogeneity in the Association Between Physical Activity and Mental Distress: A Causal Machine Learning Analysis of 3.2 Million U.S. Adults
topic Machine Learning
Applications
url https://arxiv.org/abs/2604.19066