As the global population ages, the mental health of the elderly has emerged as a critical concern in recent years. Ageism, the third major form of social prejudice following gender and racial bias, has become one of the considerable barriers to active and healthy aging. Previous studies focused on reducing prejudice from an outsider's perspective. This study aims to investigate the ageism as perceived by older adults, with a focus on the connotation and structure of perceived ageism within the context of traditional Chinese filial piety culture.

This study employed a qualitative research paradigm using the Grounded Theory method. The sampling criteria were formulated based on the purpose-oriented and intensity sampling principles, and sampling was halted upon reaching theoretical saturation. The sample included nine participants (four males and five females) with a mean age of 70 ± 7.6 years. In-depth interviews were conducted with each participant on the topic of age-related differential treatment. All interviews were recorded, transcribed into text, and then coded and analyzed using NVivo11.0 Plus and Excel software. This program included data reduction and theme generation through initial coding, focused coding, axial coding, and theoretical coding. The four stages were cyclical and iterative. In this study, a total of 155,000 words of transcripts were obtained, with 325 initial codes extracted and 909 reference points identified. These were further condensed into 71 focused codes, resulting in five core categories. The findings can be summarized into two research topics: "perceived ageism" and "responses to perceived ageism". A grounded theoretical model of perceived ageism and its responses among the elderly was then established from the bottom up. The research shows that:

(1) Perceived Ageism: This refers to age-related stereotypes and the differential treatment of the elderly in Chinese culture. Perceived ageism includes two dimensions: hostile ageism and benevolent ageism. Hostile ageism mainly includes emotional neglect, a negation of the value, affective aversion, speaking insolently, behavioral rejection, and negative labeling. Benevolent ageism mainly includes restriction of movement, exceeding one's duties, meddling in others' affairs, and overprotection for the elderly. Together, these two aspects constitute the ambivalent ageism perceived by the elderly.

(2) Responses to Perceived Ageism: This includes three dimensions: behavioral responses, cognitive responses, and emotional reactions. Older adults react differently when they experience ageism. Initially, the elderly may have emotional reaction. Confronted with hostile ageism, older adults may feel sad and guilty, while benevolent ageism tends to evoke feelings of gratitude and appreciation, albeit with potential discomfort or concern. These affective states influence the cognitive processes and behavioral responses of older adults towards aging. For instance, in a positive emotional state, the elderly may reconstruct the concept of "aging" and "ageism", leading to proactive actions, such as resistance or self-empowerment. Conversely, negative emotions may lead to a focus on negative aging information, resulting in passive behaviors such as social withdrawal. These negative cognitions and behaviors can further deteriorate the emotional experiences of the elderly, leading to a decline in self-esteem and a sense of lost value. These three elements form a virtuous or vicious cycle in coping with ageism.

(3) Implications for Filial Piety and Active Aging: From the perspective of the connotation of benevolent ageism, keeping "calm" or "rational" in filial piety may help to unlock the potential of older adults and support long-term social development. In traditional Chinese culture, both the elderly and the young should be vigilant against benevolent ageism. Society should provide older adults with the opportunity to reach their full potential. The elderly must take control of their aging process and recognize that aging is not an immutable natural law. They can achieve active aging by fostering optimistic predictions and employing positive affirmations.

The findings of this study could provide theoretical support for promoting active aging in an aging society and offer insights for younger generations on how to practice filial piety in a way that supports the well-being of older adults.