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.

Resilience allows older adults to view adversity as an opportunity for growth, making it a key resource for successful aging. This study aimed to develop and validate a multidimensional resilience scale reflecting the characteristics and experiences of community-dwelling older adults. Methods: Preliminary items were generated through a literature review and interviews with eight older adults. Content validity was evaluated by an expert panel, and 510 community-dwelling older adults were recruited using stratified age-group sampling. Construct validity was examined through exploratory and confirmatory factor analyses, while convergent and discriminant validity were also assessed. Concurrent validity was tested against the short form-12 health survey (SF-12) instrument, and Cronbach’s alpha was calculated to determine internal consistency. Results: Two items with item-level content validation index values below .80 were removed. Exploratory factor analysis of the resulting eight-item scale identified two factors (“positive growth and overcoming” and “daily adaptation and self-regulation”), explaining 54.92% of the variance. Confirmatory factor analysis indicated good model fit. Convergent validity and concurrent validity with the SF-12 were supported, while discriminant validity was not. Conclusion: The eight-item, two-factor resilience scale demonstrated acceptable validity and reliability, offering a brief and practical tool for rapid assessment of resilience in community-dwelling older adults. Further research across diverse populations is recommended to enhance its utility in evaluating health promotion programs and strategies for successful aging.