Diabetes-related exposure and screening-derived abnormality burden among older rural women in Northeast China: a secondary analysis with contextual labour-type physical activity assessment.

Background: Routine primary-care health examinations can identify clustered metabolic, renal-urinary, medication-related, and functional screening abnormalities in older adults, but their value for screening-derived abnormality-burden assessment in rural ageing populations remains underexplored. Methods: This community-based cross-sectional secondary analysis used 2025 annual health-examination data from Wangkui County, Heilongjiang Province, Northeast China. The analytic sample included 1,163 women aged ≥65 years. High screening-derived abnormality burden was constructed from routinely available screening indicators and was not intended to diagnose constipation, bowel dysfunction, frailty, or any clinical disease endpoint. Diabetes-related exposure was defined as self-reported diabetes, fasting plasma glucose ≥7.0 mmol/L, or glucose-lowering medication use. Labour-type physical activity was assessed as a secondary contextual routine-record variable using a cohort-specific index derived from weekly frequency and duration. Associations were estimated using modified Poisson regression with robust HC3 standard errors. Results: High screening-derived abnormality burden was present in 27.52% of participants, and diabetes-related exposure was present in 22.53%. Diabetes-related exposure was associated with higher abnormality burden in the primary adjusted model and remained similar after BMI adjustment (PR 1.614, 95% CI 1.329-1.961). In the key non-metabolic sensitivity analysis excluding triglycerides, HDL-C, and BMI abnormality, diabetes-related exposure remained positively associated with high non-metabolic abnormality burden (PR 1.463, 95% CI 1.077-1.988). LowActive and HighActive were not independently associated with high abnormality burden and were interpreted as contextual findings rather than as primary physical-activity evidence. Conclusion: Among older rural women, diabetes-related exposure was associated with higher screening-derived abnormality burden. Labour-type physical activity did not independently distinguish abnormality-burden status under the available crude routine-record measurement framework. This internally derived outcome should be interpreted as exploratory clustering of routine screening abnormalities for primary-care triage, not as a validated geriatric phenotype or clinical diagnostic endpoint. From an aging-and-public-health perspective, these findings suggest that routine older-adult health examinations in underserved rural communities may provide a scalable opportunity for population-level risk recognition, follow-up prioritisation, health guidance, and referral review among older women living with diabetes-related screening burden, while avoiding diagnostic over interpretation.