Based on relevant data of the central China from 2018 to 2023, this paper constructs an evaluation index system using the literature review and the Delphi method. By applying the coupling coordination degree model and the obstacle degree model, this paper empirically examines the spatio-temporal characteristics and root causes of obstacles affecting the coordinated development of TCM health resources for elderly care and the regional economy. In 2018, the regional economic level lagged behind the level of TCM health resources for elderly care, while by 2023, the regional economic level had surpassed the level of TCM health resources for elderly care. The coupling coordination degree between the two systems has significantly improved, with mean values ranging from 0.433 to 0.829. The analysis of obstacle factors shows that the insufficient application of TCM resources in elderly care settings, the inadequate support of the social security system for health and elderly care payments, the lack of dedicated fiscal investment in health and elderly care, and the service-oriented transformation of the industrial structure are the key obstacles to the coordinated development between the two systems. Based on these findings, policy recommendations are proposed to serve as references for promoting the high-quality coordinated development of TCM health resources for elderly care and the regional economy in the central region.