Can Older Adults Become Exercise Junkies? Commentary on ‘Exercise Addiction in Older Adults: Health Preservation or Fear of Death?’ by Surenkok and Colleagues

I read with interest the article in Psychogeriatrics by Surenkok et al. [1] examining exercise addiction (EA) and its psychosocial correlates in older adults. The study focuses on an often-overlooked population and raises timely questions about the motivation behind increased exercise later in life. However, several conceptual and methodological issues in the study need to be addressed to prevent overinterpretation. Exercise addiction emerged from Veale's [2] compulsive exercise characterisation, later operationalised through DSM-IV substance criteria adaptation, and the ‘components model’. First, Surenkok et al. [1] classified participants as ‘exercise addicted’ based on the Exercise Addiction Inventory (EAI) derived from the components model. However, recent methodological critiques point out that the EAI has no diagnostic value. It only measures a hypothetical risk of exercise addiction [3]. High EAI scores may also reflect increased commitment, passion, or possibly an increased risk of EA, but not dysfunction. Without clinical interviews or behavioural evidence, the distinction between high exercise affinity and pathology remains unclear. Second, a key feature of addiction, loss of control over the behaviour, was not directly assessed. Older adults may exercise frequently and vigorously while maintaining complete control and experiencing no negative physical, psychological, or social effects. The absence of control- and harm-based assessment criteria could lead to false-positive classifications, especially in groups where exercise is structured, purposeful, and health-oriented [3]. Third, the study overlooks passion for exercise, a factor shown to explain a significant portion of the variance in EA scores. Previous research indicates that when passion is statistically controlled, group differences in EA risk scores often disappear [4]. Failing to consider passion may lead to misattributing high to addiction. Indeed, the finding that 23.6% of the participants could be classified as ‘addicted’ can be an artefact of uncontrolled EA covariates [3]. In the lack of expanded operationalisation of EA, including loss of control and self-harm, this figure is questionable. Fourth, the finding that high EA-scoring older individuals reported lower health anxiety should be interpreted with caution. Physically fit older adults tend to feel healthier and, therefore, experience less health-related anxiety. Interpreting reduced health anxiety as part of an addiction profile risks reversing the causal relationship while incorrectly pathologising the positive effects of exercise [5]. Finally, I support concerns raised in recent position papers that the rapidly increasing literature on EA, mainly based on cross-sectional questionnaire studies, may be out of proportion to the small number of clinically documented problematic cases [3]. Future research in psychogeriatrics might benefit from mixed-method approaches, including behavioural control and harm criteria, and closer collaboration with clinical assessment to distinguish genuine pathology from healthy, high-level engagement. I commend the authors for initiating a stimulating line of research in psychogeriatrics. This is an important area with both theoretical and practical implications. I hope that the issues raised here contribute to a more realistic interpretation of the role of exercise in older adults, helping to avoid potential mislabelling (e.g., addiction). The author has nothing to report. The author has nothing to report. The author has nothing to report. The author declares no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.