Determinants of engagement in physical activity and exercise across the Down syndrome community.

Background: Despite the well\-established risks of physical inactivity, a large proportion of adults with Down syndrome fail to meet the world health organisations recommended physical activity guidelines and engage in high levels of sedentary behaviour. While previous research has described the amount and types of physical activity adults with Down syndrome undertake, far fewer studies have explored factors that influence this participation. Those that have are limited by geographical enrolment of participants and small sample sizes. Therefore, this study aimed to identify key factors and patterns that influence engagement in exercise and physical activity across the Down syndrome community, utilising responses from adults with Down syndrome and parents/ caregivers through an international distribution of electronic questionnaires.

Method: Two online questionnaires were distributed internationally between March and October 2025, through multiple recruitment channels, including Down syndrome\-specific charity organisations, social media platforms, and email mailing lists. Adults with Down syndrome aged ³18 years who had access to an electronic device \(N= 30\) and parents/caregivers of adults with Down syndrome took part \(N= 38\). Content within each questionnaire included sections on: \(1\) socio\-demographic status, \(2\) socio\-economic status, \(3\) physical activity, \(4\) exercise, \(5\) education, \(6\) health status, and was informed by pre\-existing validated surveys. The questionnaires were each tested before the launch to ensure clarity and relevance. A statistical multivariate regression analysis was used to determine patterns and factors strongly linked to participation in exercise and physical activity.

Results: The most notable determinant of physical activity was employment status, with individuals with Down syndrome who were employed \(including voluntary work\), demonstrating significantly higher levels of engagement in physical activity \(p < .006\). When examining exercise engagement, age and ethnicity were a significant predictor of structured and unstructured exercise engagement \(*p* < .02, *p* < .003\).

Conclusion: Findings suggest that real\-world participation, particularly engagement in the workplace, may serve as a meaningful context for promoting physical activity. Beyond work status, sociocultural factors and life stage appear to shape exercise habits. Further analysis is warranted to truly determine the influence of various factors on participation.