With the dawn of an aged society, Taiwan’s demographic structure has changed to one with low birth and mortality rates. Due to the effects of the low mortality rate, the life expectancy in Taiwan has increased, of which the increase in older people aged 65 years and above is more significant than in other age groups. According to the Republic of China Population Estimate (2022 to 2070) [1], Taiwan will become a super-aged society in 2025. In fact, Taiwan’s 65 years and above population officially transitioned into the older people’s demographic in late May 2018. The high proportion of older people has resulted in huge care and medical expenditure pressure on the Taiwanese society.

Population aging and an increase in life expectancy do not necessarily imply an improvement in the quality of life. The rise in the physically impaired population or person-years leads to considerable medical and long-term care expenses. Conversely, chronic disease is one of the leading causes of older people’s deaths globally and includes malignancies, heart disease, cerebrovascular disease, diabetes, and hypertension. Due to reduced metabolism, middle-aged and older people are susceptible to chronic disease and its complications, which increases the risk of death. It can be seen that the healthcare burden brought about by chronic disease will accompany the aged society of Taiwan. Besides affecting the physical and mental status of individuals, chronic diseases can also increase family expenditure due to healthcare, of which diabetes mellitus is common in older people.

Among the top 10 causes of death in Taiwan, cerebrovascular disease, cardiovascular disease, and nephropathy have an inseparable causal relationship with poor diabetes control. Hence, it can be seen that diabetes has a huge impact on Taiwanese. According to the National Health Insurance Administration statistics, around 2.25 million insured people sought treatment for diabetes in 2020, of which the age group with the highest number of patients was 1.13 million, which was twice the average. When viewed from the perspective of health insurance fees, the health insurance fee points per capita for diabetes in 2020 was around 11,818 points [2]. Although diabetes is not the disease with the highest medical expenditure, the costs are considerable when the points for related complications are added.

The life satisfaction of older people will decrease when they suffer from chronic diseases [3]. Overseas studies also showed that health status not only reflects an individual’s actual health but also their subjective thoughts and has direct effects on life satisfaction [4,5,6]. Frequent interactions with friends and family and moderate participation in social activities, socializing, and community activities will increase the life satisfaction of older people [3, 7,8,9,10,11]. A study also pointed out that family-based leisure services and social interaction opportunities can maintain the health status of older people and promote physical activities and social welfare in older people, particularly during the COVID-19 pandemic [12]. Leisure activities not only result in physical relaxation, promote physical and mental health, and increase physical strength but also help relieve emotional stress and improve the quality of life in older people [5, 13,14,15,16].

Recently, many studies have examined the relationship between leisure activities and health in older people. Leisure activities, such as traveling, can improve the health status of older people [17]. Another study examined the effect of different leisure activities (active or passive) on healthy aging and happiness and found that passive leisure activities may impede a socially healthy aging process in older people [18]. Col et al. [19] pointed out that leisure activities have significant effects on happiness, life satisfaction, depression, and stress levels in older people but do not have significant effects on the levels of anxiety and mental health. Kim et al. [20] used a questionnaire survey to examine the welfare development measures for older people and pointed out that the quality of life, subjective health status, and family income of older people are related to participation in leisure activities. Hakman et al. [21] provided a theoretical basis for the planning and management of older people’s leisure and health promotion activities. They pointed out that the planning and implementation of leisure and health activity plans can improve the physical working capacity, psycho-emotional state, the level of pain, cognitive functions, and the level of somatic health of older people. The study by Jeong and Park [22] showed that leisure participation and exploration are significantly correlated with depression and quality of life in older people. The study by Sala et al. [23] found that participation in leisure activities is extremely beneficial to older people as it can help them maintain healthy cognitive, physical, and mental health during aging. Zhou et al. [24] examined the relationship between leisure activities and frailty in older people and pointed out that leisure activities can decrease the risk of frailty. In addition, many studies also pointed out that leisure activity participation has many benefits for older people, such as promoting mental health [25, 26], health promotion [27, 28], improving family relationships and interpersonal interactions [29,30,31,32], and increasing financial benefits [32, 33].

In summary, in view of the huge impact of leisure activities on older people health, particularly diabetics, the primary objective of this study was to understand whether leisure activity participation by people aged 50 years and above can increase the health benefits in diabetics. The average life expectancy and the gap in healthy life expectancy were compared based on the diabetes situation of older Taiwanese people and their participation in leisure activities to examine the health benefits of leisure activities for older people with diabetes.