The mediating role of health promotion behavior on intrinsic capacity and successful aging among community-dwelling older adults: a cross-sectional investigation

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The global population is aging rapidly, increasing public health challenges and drawing greater attention to successful aging. The selective optimization with compensation theory conceptualizes successful aging as a dynamic process of adaptation, with intrinsic capacity serving as its physiological and psychological foundation. Health promotion behavior as a behavioral manifestation of individuals’ active adaptation may be relevant to the association between intrinsic capacity and successful aging. However, limited evidence is available regarding the potential mediating role of health promotion behavior in this association. Therefore, this study aimed to examine the associations among intrinsic capacity, health promotion behavior, and successful aging and to assess whether health promotion behavior statistically mediated the association between intrinsic capacity and successful aging among community-dwelling older adults. A cross-sectional survey was conducted among 336 community-dwelling older adults in Hangzhou, China. Descriptive statistics, univariate analysis, correlation analysis, linear regression analysis, and Bootstrap statistical analysis were performed using SPSS 26.0. The mean scores for intrinsic capacity, health promotion behavior, and successful aging among community-dwelling older adults were 116.15 ± 8.36, 45.10 ± 7.10, and 43.79 ± 9.60, respectively. Intrinsic capacity, health promotion behavior, and successful aging were positively correlated with one another (all P < 0.05). Mediation analysis showed statistically significant direct and indirect effects of intrinsic capacity on successful aging. Health promotion behavior statistically mediated the association between intrinsic capacity and successful aging (B = 0.219, 95% CI [0.152, 0.298]). Higher intrinsic capacity and more health promotion behaviors were associated with higher levels of successful aging. These findings suggest that both intrinsic capacity and health promotion behavior may be relevant considerations in community-based health management for older adults. Future studies involving more diverse populations and settings are needed to examine the relationships among intrinsic capacity, health promotion behavior, and successful aging. Not applicable.