Urban green infrastructure’s health impacts on aging populations remain understudied, particularly regarding gender-specific responses in cold-climate cities facing sustainability challenges. This study investigated how sustainable urban design supports healthy aging through a novel “static–dynamic” dual-temporal analysis framework. Through controlled field experiments with 345 elderly participants across three urban space types in Shenyang, China, we examined physiological indicators and psychological responses under winter conditions (4–8 °C), employing comprehensive environmental monitoring and health assessment protocols. Path analysis revealed that sustainable urban design influences health outcomes through both direct physiological pathways and indirect psychological mediation, with psychological states accounting for 56.3% of the total effect. Gender-specific analysis demonstrated that females exhibit higher environmental sensitivity (blood pressure variation coefficient: 0.171 vs. 0.079 for males) and stronger psychological mediation effects (β = −0.302 vs. β = −0.185 for males). The findings establish a theoretical foundation for implementing gender-responsive sustainable urban design strategies in cold-climate communities, demonstrating how green infrastructure can simultaneously address environmental sustainability and social equity goals while promoting healthy aging outcomes.