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AIM: Both Taiwan and China, the two most predominant Chinese-speaking regions in the world, are experiencing rapid population aging. The relationships between age and perspectives of healthy aging for older adults with chronic diseases across different settings have been underexplored. This study aimed to compare aging perceptions, physical activity, and perspectives of healthy aging among older adults with chronic diseases in Taiwan and China. It investigated whether aging perceptions and physical activity accounted for the association between age and healthy aging perspectives. METHODS: We conducted a cross-sectional study using face-to-face surveys. Participants (N = 812; 412 from Taiwan and 400 from China) aged > 60 years with one or more chronic diseases were recruited from outpatient departments and community health service centers in two coastal cities. Parallel mediation analyses were performed using PROCESS for SPSS with 5000 bootstrap samples. RESULTS: Significant differences were found between the two samples in body mass index, religious affiliation, smoking, drinking, living status, aging perceptions, and overall physical activity. In Taiwan, aging perceptions and leisure activity statistically accounted for the association between age and healthy aging perspectives, explaining 47.6% of the variance. In China, aging perceptions and health-related changes accounted for this association, explaining 21.9% of the variance. CONCLUSIONS: The pathways linking age to healthy aging perspectives among older adults with chronic diseases differed between Taiwan and China. Region-specific healthcare policies and interventions targeting aging perceptions and promoting leisure activity in Taiwan, and health-related change management in China are needed to enhance healthy aging perspectives.
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