Exploring the Mediating Roles of Aging Perceptions and Physical Activity on Healthy Aging Perspectives Among Older Adults With Chronic Diseases in Taiwan and China: A Cross-Sectional Study.
Wang Y, Lin F, et al. • Geriatrics & gerontology international • 2026
The pathways linking age to healthy aging perspectives among older adults with chronic diseases differed between Taiwan and China, with aging perceptions and leisure activity mediating the association in Taiwan, and aging perceptions and health-related changes mediating it in China.
Key Findings
Results
Significant demographic and lifestyle differences existed between the Taiwan and China samples.
Total sample was N=812, with 412 from Taiwan and 400 from China, all aged >60 years with one or more chronic diseases.
Participants were recruited from outpatient departments and community health service centers in two coastal cities.
Significant differences were found between the two samples in body mass index, religious affiliation, smoking, drinking, and living status.
Significant differences were also found in aging perceptions and overall physical activity between the two groups.
Results
In Taiwan, aging perceptions and leisure activity statistically mediated the association between age and healthy aging perspectives.
The mediation model for Taiwan explained 47.6% of the variance in healthy aging perspectives.
Parallel mediation analyses were performed using PROCESS for SPSS with 5000 bootstrap samples.
Both aging perceptions and leisure activity were identified as significant mediators in the Taiwan sample.
The relatively high proportion of variance explained (47.6%) suggests strong mediation pathways in the Taiwan context.
Results
In China, aging perceptions and health-related changes statistically mediated the association between age and healthy aging perspectives.
The mediation model for China explained 21.9% of the variance in healthy aging perspectives.
Aging perceptions and health-related changes (rather than leisure activity) were the significant mediators in the China sample.
The proportion of variance explained in China (21.9%) was notably lower than in Taiwan (47.6%).
Parallel mediation analyses were performed using PROCESS for SPSS with 5000 bootstrap samples.
Results
The mediating pathways linking age to healthy aging perspectives differed between Taiwan and China samples.
Leisure activity was a significant mediator in Taiwan but not in China.
Health-related changes were a significant mediator in China but not in Taiwan.
Aging perceptions were a significant mediator in both Taiwan and China samples.
The study used a cross-sectional design, so causal conclusions cannot be drawn.
Conclusions
Region-specific interventions are recommended to enhance healthy aging perspectives in each setting.
For Taiwan, the authors recommend targeting aging perceptions and promoting leisure activity.
For China, the authors recommend targeting aging perceptions and managing health-related changes.
The authors conclude that 'region-specific healthcare policies and interventions' are needed given the differing mediation pathways.
Both regions are described as experiencing rapid population aging, underscoring the public health relevance.
What This Means
This research studied 812 older adults (over age 60) living with at least one chronic disease in Taiwan and China to understand what factors explain why older age is associated with different views on healthy aging. The researchers found that the pathways connecting a person's age to their perspective on healthy aging were not the same in the two regions. In Taiwan, how people perceived their own aging process and how much leisure physical activity they engaged in together explained nearly half (47.6%) of the relationship between age and healthy aging views. In China, aging perceptions and how people managed health-related changes in their bodies explained a smaller but still meaningful portion (21.9%) of that same relationship.
This research suggests that simply promoting physical activity or positive aging attitudes may not be equally effective across different Chinese-speaking communities. In Taiwan, encouraging leisure-time physical activities (such as recreational exercise or sports) alongside efforts to improve how people think about growing older may be especially important. In China, helping older adults better manage and adapt to the physical changes that come with aging and chronic disease may be more impactful. Aging perceptions — that is, how people think and feel about their own aging — appeared to matter in both settings.
The study highlights that even within closely related cultural groups, local context shapes the factors that support healthy aging. Policy makers and healthcare providers in each region may need tailored approaches rather than one-size-fits-all programs. Because this was a cross-sectional study (a snapshot in time rather than a follow-up over time), it cannot prove that changing these factors would directly improve healthy aging perspectives, but it does point to promising targets for future interventions and research.
Wang Y, Lin F, Ye L, Yu L, Kang J, Biddle M, et al.. (2026). Exploring the Mediating Roles of Aging Perceptions and Physical Activity on Healthy Aging Perspectives Among Older Adults With Chronic Diseases in Taiwan and China: A Cross-Sectional Study.. Geriatrics & gerontology international. https://doi.org/10.1111/ggi.70809