Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 2 2025 02 08 424 434 Yang Bai 1. School of Architecture and Design, Harbin Institute of Technology, Harbin, China 2. Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China Hong Jin 1. School of Architecture and Design, Harbin Institute of Technology, Harbin, China 2. Key Laboratory of Cold Region Urban and Rural Human Settlement Environment Science and Technology, Ministry of Industry and Information Technology, Harbin, China Hua Bai 1. School of Economics, Fujian Normal University, Fuzhou, China 2. School of Economics and Management, University of Chinese Academy of Science, Beijing, China 3. China Institute of Science and Technology Evaluation, Beijing, China 2024 11 20 2025 02 08 Background: Mental health issues are increasingly prevalent in older adults as the population ages. The relationship between psychological restoration and environmental perception preferences in older adults residing in the severe cold region is investigated in this study. Methods: Six urban public areas in severe cold regions were selected as research sites, and 1093 older adults were surveyed using a questionnaire in this investigation. The questionnaire included an environmental perception preference scale and the Restorative Outcome Scale. Results: Environmental perception preferences substantially influence psychological restoration in older adults (η² = 0.130, P < 0.001), and a notable interaction is observed between perception preferences and seasonal variations (η² = 0.065, P < 0.001). Preferences for vegetation exert the most substantial positive influence on psychological restoration during spring and summer. In winter, preferences for recreational activities are paramount; whereas in autumn, preferences for people are identified as critical for psychological restoration. Conclusion: In severe cold regions, psychological restoration is influenced not only by environmental perception preferences but also by climate fluctuations. This study provides valuable insights, assisting designers in developing restorative environments for older adults residing in severe cold areas. https://ijph.tums.ac.ir/index.php/ijph/article/view/37251 https://ijph.tums.ac.ir/index.php/ijph/article/download/37251/8478