Abstract
BackgroundNepal’s demography is aging rapidly, yet few studies to date have examined how this has affected the health and well-being of the elderly, defined as those above 60 years in Nepal’s Senior Citizen Act (2006). Our study, abbreviated NepEldQOLII, aims to assess perceived life satisfaction, and evaluate its relationship with nutritional health and mental well-being among the burgeoning Nepalese elderly population.MethodsA cross-sectional survey among 289 Nepalese elderly, aged ≥60 years, attending an outpatient clinic of a hospital in Kathmandu, Nepal was conducted. Nutritional status, depression, and life satisfaction were assessed by a mini-nutritional assessment scale (range: 0–14), a geriatric depression scale (range: 0–15), and a satisfaction with life scale (range: 5–35), respectively. Mediation analyses, adjusted for age, sex, marital status, and family type, were used to assess mediating relationships between nutritional and mental wellbeing with life satisfaction as the outcome.ResultsApproximately 21% of the participants were dissatisfied with their life. Life satisfaction was positively associated with being married, high family income, involvement in active earning, and a high nutritional score. Conversely, life satisfaction was inversely associated with living in a nuclear (as opposed to joint) family, the perception of having worse health than peers, the perception of being ignored/hated due to old age, and a higher depression score. In mediation analyses, both nutrition (β = 0.48, bias-corrected and accelerated (BCa) 95% CI: 0.27, 0.69) and depression (β = − 0.87, BCa 95% CI: -1.01, − 0.74) had significant direct associations with life satisfaction. Furthermore, both nutrition (β = 0.30, BCa 95% CI: 0.13, 0.49) and depression (β = − 0.07, BCa 95% CI: -0.14, − 0.03) mediate each other’s association with life satisfaction. Nutritional score mediated 7% of the total association between depression and life satisfaction; depression mediated 38% of the total association between nutrition and life satisfaction.ConclusionsLife satisfaction shows a pattern of decline as nutritional and mental health status decrease. Both depression and under-nutrition had a significant association with life satisfaction. The pathway by which nutrition affects life satisfaction is influenced by depression as a mediator. Moreover, nutritional status explained a small portion of the relationship between depression and life satisfaction. These observed preliminary findings should be confirmed in future longitudinal studies.
Highlights
Nepal’s demography is aging rapidly, yet few studies to date have examined how this has affected the health and well-being of the elderly, defined as those above 60 years in Nepal’s Senior Citizen Act (2006)
A greater proportion of participants satisfied with their life were married, had higher family income, lived in a joint family, had better-perceived health status compared to peers, were not depressed or ignored/hated due to old age, and had normal nutritional status (Table 1)
Compared to participants living in a joint family, those living in a nuclear family were significantly less satisfied (β = − 2.37; bias-corrected and accelerated (BCa) 95% confidence intervals (CI) = − 4.79, 0.01)
Summary
Nepal’s demography is aging rapidly, yet few studies to date have examined how this has affected the health and well-being of the elderly, defined as those above 60 years in Nepal’s Senior Citizen Act (2006). The population of elderly, defined as adults 60 years of age and above by the Nepali Senior Citizens Act [3], has increased from 1.5 million in 2001 to 2.2 million in 2011 [4]. This represents a 3.5% growth rate for the elderly and exceeds the 1.4% overall population growth rate in Nepal [4]. Life satisfaction can serve as a general indicator of health risk [7] and successful aging [9]
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