Comparing Perception of Aging, Quality of Life, and Their Association Among Urban and Rural Older Adults

Amini, Mohaddeseh; Mohammadi-Shahboulaghi, Farahnaz; Dinmohammadi, Mohammadreza; Noroozi, Mehdi

doi:10.22059/jhae.2026.407889.1027

Comparing Perception of Aging, Quality of Life, and Their Association Among Urban and Rural Older Adults

Document Type : Original research

Authors

Mohaddeseh Amini ¹

Farahnaz Mohammadi-Shahboulaghi ²

Mohammadreza Dinmohammadi ³

Mehdi Noroozi ⁴

¹ Department of Nursing, Faculty of Behavioral Sciences and Mental Health, University of Social Welfare and Rehabilitation Sciences Tehran, Iran.

² Professor of Iranian Research Center on Aging, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

³ Associate Professor Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

⁴ Assistant Professor of Epidemiology Department of Psychiatry Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

10.22059/jhae.2026.407889.1027

Abstract

Introduction: Older adults’ perceptions of aging may be associated with their quality of life and may differ across urban and rural living environments. Understanding these differences can help develop context-sensitive supportive programs. This study aimed to compare perceptions of aging, quality of life, and the association between them among urban and rural older adults in Khoy County, West Azerbaijan Province, Iran, in 2024.
Methods: This cross-sectional descriptive-correlational study was conducted on 199 older adults aged 60 years and above, including 99 urban and 100 rural participants. A multistage systematic sampling method was used among eligible older adults covered by urban and rural comprehensive health centers. Data were collected using a demographic questionnaire, the Abbreviated Mental Test, the Aging Perceptions Questionnaire, and the Older People’s Quality of Life Questionnaire. Data were analyzed in SPSS version 23 using descriptive statistics, independent t-test, Mann–Whitney U test, chi-square/Fisher’s exact test, and Spearman correlation.
Results: The mean perception of aging score was higher among urban older adults than rural older adults. Similarly, the mean quality of life score was higher in the urban group, with significant differences in all dimensions except culture and religion. A positive and significant correlation was found between perception of aging and quality of life in both urban and rural groups.
Conclusion: More positive perceptions of aging were associated with higher quality of life among older adults. Given the cross-sectional design, the findings should be interpreted as associations rather than causal relationships.

Keywords

Aging perceptions

Quality of life

Older adults

Urban–rural differences

Aging Perceptions Questionnaire (APQ)

OPQOL-35

Subjects

Rehabilitation

Introduction

In recent decades, advances in medical care, public health, and living conditions have substantially increased life expectancy, contributing to the rapid growth of the older adult population worldwide. As a result, gerontological research has increasingly shifted from merely extending lifespan to promoting healthy aging and improving quality of life (QoL). Among the psychological determinants of well-being in later life, perceptions of aging—defined as individuals’ beliefs, interpretations, and emotional responses toward the aging process—have received growing attention. Evidence suggests that more positive perceptions of aging are associated with greater psychological resilience, better health-related behaviors, and higher life satisfaction, whereas more negative perceptions are linked to depressive symptoms, anxiety, and reduced social participation.

Perceptions of aging do not develop in isolation; rather, they are shaped by environmental, social, and cultural contexts. Living environment may play a particularly important role, as urban older adults typically have greater access to healthcare services, recreational facilities, and educational opportunities, while rural older adults may benefit from stronger social cohesion and community support but encounter barriers related to limited infrastructure and fewer formal resources. Clarifying how these contextual differences relate to perceptions of aging and QoL can inform the design of context-sensitive policies and interventions aimed at reducing disparities and promoting well-being in later life.

Accordingly, the present study aimed to (1) compare the mean levels of perceptions of aging and QoL and (2) examine and compare the association between perceptions of aging and QoL among urban and rural older adults in Khoy County, Iran, in 2024.

Methods

This cross-sectional, descriptive-correlational study was conducted on 199 elderly individuals aged 60 years and older who attended urban and rural comprehensive health centers in Khoy County. A multistage systematic sampling method was used. First, two urban and two rural comprehensive health centers were selected, and then eligible older adults were systematically selected from the electronic health records of the selected centers. Inclusion criteria included being 60 years or older, willingness to participate, and the absence of diagnosed cognitive or psychiatric disorders. Data were collected using four validated instruments: a demographic questionnaire, the Abbreviated Mental Test (AMT) to screen cognitive status, the Aging Perceptions Questionnaire (APQ) to assess beliefs and attitudes toward aging, and the Older People’s Quality of Life Questionnaire (OPQOL-35) to evaluate multidimensional aspects of QoL including physical health, psychological well-being, social relationships, environment, and cultural-religious domains.

Data were analyzed using SPSS version 23. Descriptive statistics (mean, standard deviation) and inferential tests such as independent t-test, Mann–Whitney U test, chi-square, and Spearman correlation were employed. Statistical significance was set at p < 0.05.

Results

The study included 102 men (51.3%) and 97 women (48.7%) with a mean age of 71.12 ± 7.99 years. Urban elderly showed a significantly higher mean score in perception of aging (118.2 ± 22.82) than rural elderly (110.43 ± 20.18), indicating a more positive outlook toward the aging process among urban participants. Similarly, the total quality of life score was significantly greater in the urban group (117.59 ± 14.51) compared to the rural group (109.82 ± 13.84). Among the QoL subdomains, all dimensions except “culture and religion” demonstrated significantly higher scores among urban elderly.

Furthermore, a positive and statistically significant correlation was found between perception of aging and quality of life in both groups—stronger in urban (r = 0.413, p < 0.001) than in rural elderly (r = 0.268, p < 0.001). These findings suggest that individuals with a more positive view of aging also report higher satisfaction and well-being in different aspects of life. Differences between the two groups can be attributed to environmental conditions, access to social and healthcare resources, and economic stability.

Conclusion

This study highlights the crucial role of the perception of aging as a psychological determinant of quality of life in later life. The results demonstrate that urban elderly generally experience better QoL and a more positive perception of aging compared to their rural counterparts. Since attitude toward aging can be modified through education and supportive interventions, programs aimed at promoting a positive self-perception of aging may contribute to improved health outcomes and life satisfaction among older adults.

Health policymakers and geriatric care providers are recommended to design targeted interventions that strengthen elderly individuals’ self-concept and perception of aging, especially in rural areas where limited access to services may compromise overall well-being. Emphasizing the development of educational, social, and community-based initiatives can foster active, healthy aging and reduce urban–rural disparities in the quality of life among older adults.

Footnotes

Ethical approval

This study was approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences, Tehran, Iran (Ethics Code: IR.USWR.REC.1403.216). Written informed consent was obtained from all participants, and confidentiality of data was strictly maintained.

Funding

This research received no financial support from any governmental, academic, or private organization.

Authors’ contribution

M.A: Conceptualization, study design, data collection, analysis, and manuscript drafting.

F.M.S: Supervision, project guidance, and critical revision of the manuscript.

M.D.M: Consulting on theoretical framework and interpretation of findings.

M.N: Statistical consultation and data analysis.

All authors reviewed and approved the final version of the manuscript.

Conflict of interest

The authors declare no conflict of interest related to this study.

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