Destination loyalty is a key indicator of the competitiveness of tourist destinations. Rural summer health leisure vacations for urban elderly (RSHLVUE) tourists span a wide range of ages. Destination operators need to understand the loyalty formation mechanisms of different aged tourists. RSHLVUE tourists were divided into a low-aged group (LA) and a high-aged group (HA) to examine and modify the hypothesis of the relationship between perceived value, tourist well-being, place attachment, and destination loyalty based on affect, behavior, and cognition (ABC) theory. The test results of the measurement model indicate that the HA showed stronger responses in terms of cost value, sense of meaning, and place dependency. The formation mechanism of destination loyalty for the LA is tourist well-being → perceived value → place attachment → destination loyalty, and for the HA is perceived value → tourist well-being → place attachment → destination loyalty. The findings deepen the understanding of destination loyalty among elderly leisure vacation tourists and can guide RSHLVUE destination managers to enhance destination competitiveness.