Purpose: This study aimed to identify the influencing factors of healthy aging (HA) among frail older adults based on the activity theory of aging. We examined the relationship between perceived health (PH) and HA, with social activity participation (SAP) as a mediator and sex as a moderator. Methods: Secondary data analysis was conducted using data from a national survey of 505 frail older adults in Korea, including measures of PH, SAP, and HA. Analysis utilized SPSS/WIN 29.0 and PROCESS Macro v.4.2 (Model 14). Results: PH was positively correlated with SAP (r=.18, p<.001) and HA (r=.43, p<.001), while the relationship between SAP and HA was not significant (r=-.07, p=.107). PH showed a statistically significant indirect effect on HA through SAP (β=-0.05, BootCI -0.12~-0.01), indicating that PH influenced HA both directly and indirectly via SAP. Sex significantly moderated the association between SAP and HA (β=0.24, BootCI 0.08~0.40), such that SAP was negatively associated with HA in men, whereas no significant association was observed in women. The moderated mediation index was small but significant (β=0.06, BootCI 0.004~0.15). Conclusion: PH and SAP were significant determinants of HA among frail older adults, with the mediating role of SAP differing by sex. Although activity theory posits that social engagement promotes HA, these findings suggest that sex-specific patterns and individual preferences in social activities should be considered when designing interventions to support HA.
Choi et al. (Fri,) studied this question.