Predictors of aging perception among community dwelling older adults attending primary care centers in Qazvin

Abstract

Aging perception significantly influences quality of life and health outcomes in older adults, yet its predictors in non-Western contexts remain underexplored. This study aimed to identify demographic, psychosocial, and health-related factors associated with aging perception among community-dwelling older adults in Iran, and to examine whether key predictors interact in shaping aging perception. A cross-sectional study was conducted from March to November 2025 in primary healthcare settings in Qazvin, Iran. Using multi-stage cluster sampling, 370 adults aged 60 years and older were recruited from six community healthcare centers, three family physician clinics, and two elderly day-care centers. Data were collected via interviewer-administered questionnaires assessing demographics, loneliness, self-rated health, perceived social support (Multidimensional Scale of Perceived Social Support), life satisfaction (Satisfaction with Life Scale), and aging perception (Aging Perceptions Questionnaire). Descriptive statistics, bivariate analyses, hierarchical multiple linear regression with interaction terms, and stratified subgroup analyses were performed to identify predictors. Participants had a mean age of 67.99 ± 5.96 years, with a moderately positive aging perception score (100.07 ± 5.86). The main-effects regression model explained 42% of the variance in aging perception (adjusted R² = 0.42). Independent positive predictors included university education (β = 0.23, p = 0.020), living with children (β = 0.21, p = 0.032), living alone (β = 0.41, p < 0.001), higher life satisfaction (β = 0.15, p = 0.021), and higher perceived social support (β = 0.16, p = 0.013). Negative predictors were male gender (β = -0.20, p = 0.031), being single (β = -0.37, p < 0.001), and being widowed (β = -0.32, p = 0.004). The addition of interaction terms (education × social support, living arrangement × marital status, gender × intergenerational cohabitation) significantly improved the model (ΔR² = 0.05, p = 0.008), with a significant education × social support interaction (β = 0.14, p = 0.011): the positive association between university education and aging perception was strongest among participants with high perceived social support. Sociodemographic and psychosocial factors play key roles in shaping aging perception in Iranian older adults. Findings are consistent with Levy’s Stereotype Embodiment Theory and suggest that social resources amplify the benefits of education. Interventions targeting education, social support, and family integration could promote positive perceptions, enhancing well-being in aging populations. However, given the facility-based sampling and cross-sectional design, these associations should be interpreted cautiously and confirmed in longitudinal, population-representative studies.

The authors' abstract, as published at the source. BMC Public Health, 2026 · DOI ↗