Introduction

By 2050, it is estimated that one in four people will be over 60 years old, with the fastest relative increase in the over-80 age group [1]. The problems that old age bring and the adaptation to it can influence the assessment of the quality of life of the elderly [2]. With an ageing population and an increase in the number of older people in the population, the assessment of life satisfaction, quality of life, and mental health in old age is a subject of increased interest. Perceptions of life satisfaction, happiness, and quality of life are always very individual. Many physical and mental losses can cause personal discomfort, but coping with these difficulties can help elderly people experience satisfaction with life even in a changed situation [3, 4].

Several authors have defined life satisfaction. For example, Diener et al. [5] defines life satisfaction as cognitive assessment of the overall quality of life. The concept of life satisfaction can also be defined as a feeling of satisfaction with how a person has lived their life up to now and how they evaluate satisfaction with their current life [6]. Most definitions of life satisfaction emphasize the subjectivity of assessment. People are satisfied and happy when they feel that way or when they say that they feel that way (subjectively evaluating that they are satisfied with life and talking about it). Our research was based on this fact. We assume that people have life satisfaction if they feel that way themselves regardless of other circumstances [7]. In the process of assessing life satisfaction, individuals consider the personal priorities of their life, consider it as a whole, weigh the good with the bad, and define it as more or less satisfactory [8].

Contentment with life in old age is considered a success for older people and is associated with healthy ageing and full adaptation to old age [9]. It is also taken as an indicator of better quality of life [10] and successful ageing [11, 12]. It also benefits from better physical health [13] and a lower risk of depression [14]. If an older person is not satisfied with his or her life, he or she may begin to experience despair. Sone et al. [15] found that subjectively perceived life satisfaction can protect the brain from accelerated ageing.

Furthermore, research suggests that the satisfaction of life of older people is influenced by a number of factors that merit investigation. They are related to the level of education, finances, self-assessment of health, satisfaction with social support, and cohabitation in the common household [16]. The influence of psychosocial factors is also confirmed by other research [17–19]. In particular, decreases in social connections and physical functioning in the elderly population are the most frequently reported negative aspects of ageing, thus reducing life satisfaction [20]. Puvill et al. [21] found that mental health has a greater influence on life satisfaction than physical health. The satisfaction of life for older people may also be related to physical activity. The systematic review of Bai et al. [22] provides limited evidence showing the effect of physical activity (fast and moderate walking) on life satisfaction.

Scientific research should aim to identify the key factors that influence the satisfaction of life and quality of life of older people [23]. This can be beneficial for identifying appropriate preventive and policy measures that can have a positive effect on improving the life satisfaction of elderly people, and thus their personal well-being, quality of life, and contribution to maintaining their health.

The aim of this cross-sectional study was to identify the satisfaction of life of older people living in a community environment and to identify what predictors influence it. Based on the abovementioned research, we assumed that life satisfaction may be influenced by both health conditions (physical and psychological) and psychosocial factors.

Materials and methods

Results

The socio-demographic characteristics of the population are shown in Table 1. Elderly patients also reported how many diseases they were regularly treated for. The average number of diseases per older person was found to be 2.6. The most frequent older people reported being treated for cardiovascular (62.8%) and musculoskeletal (49.1%), sensory (31.9%), and urological diseases (19.4%).

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Table 1. Socio-demographic and health characteristics of sample (n = 1 121).

https://doi.org/10.1371/journal.pone.0283772.t001

The total life satisfaction score was 36.34 (CI = 35.83–36.85), standard deviation = 8.66, median = 36.00, min-max = 12–62, skewness = 0.144, kurtosis = -0.264, see Fig 1. Older people reported the highest moderate satisfaction (n = 682; 60.8%). A total of 170 (15.2%) older people reported high satisfaction. On the contrary, 262 (23.4%) older people reported moderate dissatisfaction, and only 7 (0.6%) older people reported high dissatisfaction.

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Fig 1. Contribution of LSITA_SF12 scale.

https://doi.org/10.1371/journal.pone.0283772.g001

First, we evaluated the difference in life satisfaction scores for the individual groups of older people. Table 2 shows that a statistically significant difference was found in all monitored parameters. Women reported higher life satisfaction, then employed older people, older people living with someone in the same household, married, under 75 years of age, subjectively assessing their health as good or very good, with no signs of depression (GDS<5) and higher self-esteem scores (RSES>15).

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Table 2. Evaluation of differences in life satisfaction according to selected factors.

https://doi.org/10.1371/journal.pone.0283772.t002

A correlation was found between higher life satisfaction ratings and lower rates of depression (r = 0.688; p<0.001) and anxiety (r = 0.450; p<0.001). A correlation was also found between higher life satisfaction ratings and better cohesion ratings for SOC (r = -0.532; p<0.001), SOC_C (r = -0.545; p<0.001), SOC_MA (r = -0.357; p<0.001), SOC_ME (r = -0.560; p<0.001), RSES self-esteem (r = -0.519; p<0.001), quality of life (r = 0.592; p<0.001), social support (r = 0.292; p<0.001), subjective health (r = -0.416; p<0.001), and lower age (r = 0.223; p<0.001).

Tables 3 and 4 show predictors of life satisfaction for older people. Two models that included health and psychosocial factors were tested. Health factors included both mental and physical health. Both models were confirmed to be statistically significant. The predictors explained 41.2% of the variation in health factors and 51.3% of the variation in psychosocial health factors. The predictors of better life satisfaction are both health factors (better subjective health assessments, lower depression and anxiety) and psychosocial factors (better quality of life assessments, self-esteem, sense of coherence, lower age, and better social support assessments).

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Table 3. Multiple regression analysis with the health factors as independent variables and the life satisfaction as dependent variables (model 1).

https://doi.org/10.1371/journal.pone.0283772.t003

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Table 4. Multiple regression analysis with the psychosocial factors as independent variables and the life satisfaction as dependent variables (model 2).

https://doi.org/10.1371/journal.pone.0283772.t004

Discussion

The aim of our research was to find out what factors influence the life satisfaction of the elderly. Based on previous research, we assumed that life satisfaction might be influenced by psychosocial factors, as well as by the assessment of mental and physical health. Life satisfaction in the elderly is an important topic because it can play a crucial role for successful ageing [9, 11, 12], the quality of life of the elderly [10], their physical health [13], the reduction of depression [14], as well as hopelessness [33]. Jose, George and Dante [34] found that older people with high levels of life satisfaction experience relatively low levels of anxiety about death and vice versa. These are the reasons why policy measures should contribute to influencing factors that contribute to better life satisfaction.

In our research, it was confirmed that the predictor of life satisfaction is the subjective assessment of both physical and mental health, anxiety, and depression (model 1). Differences were also found when comparing between groups. Older people who had at least mild depression reported worse life satisfaction. Similarly, older people who evaluated their physical health as fair or poor reported lower life satisfaction. In previous research, the existence of chronic diseases [10, 35, 36], physical limitations in everyday life [35], depression [35, 37], and anxiety [18] were found to be the main determinants of life satisfaction. Older people with better health status showed greater satisfaction. Puvill et al. [21] demonstrate the greater impact of mental health compared to physical health. Depression is considered the most common mental health problem among older people and the most common psychiatric disorder [38] that negatively affects the life of older people [39]. Geriatric depression increases the risk of other diseases, cognitive impairment, and premature death or suicide, and it increases the cost of treatment [40]. Of the psychological factors that influence life satisfaction, it may not only be anxiety and depression, but also fear [41]. Especially in this day and age, when older people are threatened by fear of COVID-19, isolation, or war, it can become a significant predictor. However, this factor has not been investigated in our investigation.

The second model tested confirmed the influence of psychosocial factors such as quality of life, self-esteem, sense of coherence, age, and social support on the evaluation of life satisfaction. Social support in our research was tested only by the subjective view of the person surveyed by one question, which represents a certain limit of research. On the other hand, it is the subjective perception of social support that can indicate satisfaction or dissatisfaction with social support, regardless of the number of people and contacts the person has.

Sex, education, employment, cohabitation, and religion were also found in the difference testing. The improved life satisfaction was reported in our research by women, as well as older people who are in the labour force, live with someone in the same household, are married/divorced, are religious, and rate their self-esteem better.

Social support [10, 18, 36], living in a marriage, or possibly cohabiting with another person in the same household [7, 10, 42], can make a significant contribution to the life satisfaction of the elderly, as evidenced by previous research. Widows reported lower life satisfaction. Among widows, older people with more children were better off [42]. In addition to family relationships, it can also be the level of other social interactions that influence how older people assess their life satisfaction [35].

Pan et al. [37] compared the influence of social factors and physical functioning. Social functioning measured by the number of people living together, social support, and the sense of loneliness contributed more to life satisfaction than physical functioning (self-perceived health, ADL, IADL, number of chronic illnesses).

Age was also found to be a predictor of life satisfaction in our research. Older people under 75 years of age showed greater satisfaction. In the research of Tavares et al. [35], life satisfaction increased with age from the age group 70–74 years. Pan et al. [37] found that older age and lower levels of education were associated with higher levels of life satisfaction.

Some research has focused on other factors where the positive influence of hope has been demonstrated [2, 42, 43], such as spiritual well-being [2] and sufficient satisfaction of physical and psychological needs [17].

In our research, we tested self-esteem and sense of coherence, which have not been tested as predictors of life satisfaction in previous research. The author who coined the term “sense of coherence” is Antonovsky [28], who talks about understanding the image of the world as a meaningful whole and considers this factor to be a salutor—i.e., a positive factor improving health despite adverse environmental influences. Zielinska-Wieczkowska et al. [23] state that the sense of coherence (SOC) is one of the most important factors determining life satisfaction and the ability to cope with difficult situations accompanying old age. Meaningfulness of life is then an important motivating element, stimulating one to understand the outside world, in a difficult situation that can be typical for the elderly. A person with strong SOC will be able to cope with many difficult life situations, which will contribute to their life satisfaction. A fundamental result of our research is confirmation of the knowledge that sense of coherence and self-esteem positively influence the assessment of life satisfaction.

Further research should focus on effective preventive strategies that support mental health, including reducing symptoms of anxiety and depression and increasing the quality of life or sense of coherence of the elderly [44]. Salvi [38] recommends using psychosocial interventions such as cognitive behavioural therapy, reminiscence therapy, problem-solving therapy, or cognitive therapy (mindfulness-based cognitive therapy) for the prevention and treatment of depression [39] investigated the effectiveness of interventions that promote a positive understanding of ageing and create a positive attitude toward old age among the elderly. They found that positive psychological interventions have positive effects on mental well-being and the reduction of depression and anxiety among older people, improving life satisfaction, hope, and positive emotions. In addition to psychosocial interventions, some studies have also shown a positive effect of educational programs within third-age universities [45–48]. Older people can gain increased life satisfaction, self-esteem, and self-confidence through third-age university programmes. At the same time, they have more social interactions that can reduce their loneliness. Further research should focus on the effectiveness of these measures.

Conclusion

In our research, predictors of the life satisfaction of older people living in a community have been confirmed, both health factors (subjective health assessment, anxiety, and depression) and psychosocial factors (quality of life, self-esteem, sense of coherence, age, and social support). In implementing policy measures, these areas should be emphasized. The availability of educational and psychosocial activities in community care for older people is appropriate, as well as the motivation of older people to participate in these activities.

Supporting information