Neighborhood physical environment satisfaction and aging attitudes in older Chinese adults: Differences by chronic condition status

• Neighborhood satisfaction links to positive aging attitudes in older Chinese adults. • Road, sanitation, and lighting satisfaction mattered for those with chronic conditions. • No significant neighborhood effects were found among older adults without conditions. • Findings highlight the need for age-friendly environments to support healthy aging. With China’s aging population and rising prevalence of chronic conditions, it is crucial to understand the factors shaping aging attitudes. Satisfaction with the neighborhood physical environment may play an important role, particularly among those with chronic health issues. To examine the association between neighborhood physical environment satisfaction and aging attitudes among older Chinese adults, and to explore differences across groups with and without chronic conditions. We analyzed data from 11,395 participants aged 60 and above from the 2020 China Longitudinal Aging Social Survey (CLASS). Stratified multiple regression analyses were conducted, comparing subgroups with chronic conditions (n=8,405, 73.76%) and without chronic conditions. Among participants with chronic conditions, higher satisfaction with road conditions (β = 0.382, P = 0.001), environmental sanitation (β = 0.286, P = 0.007), and road/street lighting (β = 0.288, P = 0.005) was significantly associated with more positive attitudes toward aging. No significant associations were found among participants without chronic conditions. Age-friendly neighborhood environments are important for promoting positive aging attitudes, particularly among older adults living with chronic conditions. These findings offer valuable insights for policymakers, researchers, and service providers aiming to support healthy aging in rapidly aging societies like China.