Effects of Forest Therapy on Quality of Life among Middle-aged and Older Adults: A Comparative Analysis by Age Group and Socioeconomic Status
1
Department of Forest Environmental Resources, Gyeongsang National University, Jinju, Republic of Korea
2
Korea Forest Welfare Institute, Daejeon, Republic of Korea
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Middle-aged and older adults face increasing vulnerability to chronic disease, functional decline, and social isolation with aging. These challenges are complex to address through medical treatment alone, underscoring the need for preventive approaches that enhance physical and mental well-being in daily life. Nature-based interventions(NBIs), including forest therapy, have demonstrated psychological and physiological benefits for older adults; however, evidence on differential effects by age and socioeconomic status remains limited. This study compared the effects of a forest therapy program across age groups and examined effect sizes by income level and self-rated health.
METHODS:
A pre–post intervention study was conducted with 939 middle-aged and older adults participating in a forest therapy program operated by the Korea Forest Welfare Institute. Participants were categorized into two age groups: 50s–60s(n=459) and 70s–80s and older(n=480). Quality of life was assessed using the World Health Organization Quality of Life-BREF(WHOQOL-BREF). Subgroup analyses by income level and self-rated health were conducted using paired t-tests, one-way ANOVA with Tukey HSD post-hoc tests, and multiple regression analysis.
RESULTS:
Quality of life improved significantly in both age groups(p<0.001). The 70s–80s and older group showed larger effect sizes(Cohen’s d=0.92, CI: 0.81-1.02) than the 50s–60s group(d=0.60, CI: 0.50-0.70). Low-income participants in the older group exhibited the greatest improvement(+1.90, d=1.19). Participants with poor self-rated health demonstrated larger effects (d=1.16 in the older group). Multiple regression analysis showed that self-rated health(β=-0.42, p<0.001) and age group(β=0.17, p<0.001) significantly predicted improvement(R²=0.49).
CONCLUSIONS:
Forest therapy, as a non-pharmacological intervention, significantly improved Quality of life among middle-aged and older adults, with the strongest effects observed in low-income individuals aged 70 and older. These findings suggest that the benefits of forest therapy vary by age and socioeconomic status. NBIs may represent an effective public health strategy to promote healthy aging and advance health equity.
Middle-aged and older adults face increasing vulnerability to chronic disease, functional decline, and social isolation with aging. These challenges are complex to address through medical treatment alone, underscoring the need for preventive approaches that enhance physical and mental well-being in daily life. Nature-based interventions(NBIs), including forest therapy, have demonstrated psychological and physiological benefits for older adults; however, evidence on differential effects by age and socioeconomic status remains limited. This study compared the effects of a forest therapy program across age groups and examined effect sizes by income level and self-rated health.
METHODS:
A pre–post intervention study was conducted with 939 middle-aged and older adults participating in a forest therapy program operated by the Korea Forest Welfare Institute. Participants were categorized into two age groups: 50s–60s(n=459) and 70s–80s and older(n=480). Quality of life was assessed using the World Health Organization Quality of Life-BREF(WHOQOL-BREF). Subgroup analyses by income level and self-rated health were conducted using paired t-tests, one-way ANOVA with Tukey HSD post-hoc tests, and multiple regression analysis.
RESULTS:
Quality of life improved significantly in both age groups(p<0.001). The 70s–80s and older group showed larger effect sizes(Cohen’s d=0.92, CI: 0.81-1.02) than the 50s–60s group(d=0.60, CI: 0.50-0.70). Low-income participants in the older group exhibited the greatest improvement(+1.90, d=1.19). Participants with poor self-rated health demonstrated larger effects (d=1.16 in the older group). Multiple regression analysis showed that self-rated health(β=-0.42, p<0.001) and age group(β=0.17, p<0.001) significantly predicted improvement(R²=0.49).
CONCLUSIONS:
Forest therapy, as a non-pharmacological intervention, significantly improved Quality of life among middle-aged and older adults, with the strongest effects observed in low-income individuals aged 70 and older. These findings suggest that the benefits of forest therapy vary by age and socioeconomic status. NBIs may represent an effective public health strategy to promote healthy aging and advance health equity.
| eISSN: | 2654-1459 |
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