Background <p>Limited research has examined climate anxiety among older adults. Existing studies on climate anxiety and quality of life primarily address younger populations. These populations demonstrate greater adaptation and coping skills in response to environmental change. In contrast, older adults with chronic conditions experience increased vulnerability to climate-related stressors. They frequently display patterns of helplessness, anxiety, and avoidance.</p> Methods <p>This cross-sectional study recruited 424 older adults (mean age, 67.47; SD, 10.12; range, 60–92) with chronic conditions (hypertension, diabetes, chronic obstructive pulmonary disease, cardiovascular disease ) from the community in Hangzhou, China, using convenience sampling. The study used validated instruments, including the Climate Anxiety Scale, the Coping with Climate Change Scale, and the Older Adults’ Quality of Life–Brief Scale. All instruments underwent translation and back-translation. They were also reviewed by experts and pilot-tested.</p> Results <p>Quality of Life was 2.33 (± 0.58), Coping with Climate Change was 2.66 (± 0.37), and Climate Anxiety was 3.25 (± 0.46). The study confirmed an association between climate anxiety and quality of life. Coping with climate change mediated this relationship. Climate anxiety significantly influenced coping with climate change (B = 0.26, <i>p</i> &lt; .001), explaining 11% of the variance. Both climate anxiety and coping with climate change significantly affected quality of life (B = 0.32 and 0.76, <i>p</i> &lt; .001). These factors accounted for 39% of the variance. The total, direct, and indirect effects of coping with climate change were 0.51, 0.31, and 0.20, respectively.</p> Conclusion <p>Public health policymakers, community health service organizations, and clinical practitioners should work together to enhance the climate resilience of older adults. They can do this through individual skills training, increased community support, and the development of targeted policies.</p>