# Quality of Life as a Predictor of Successful Aging in Urban and Rural Older Adults: A Cross-Sectional Study in Eastern Croatia–Slavonia

## TL;DR

Rural older adults report lower successful aging and wellbeing than urban ones, with personal wellbeing being a key predictor.

## Contribution

Identifies personal wellbeing as the strongest predictor of successful aging and highlights rural disparities in quality of life.

## Key findings

- Rural older adults had lower self-rated successful aging and personal wellbeing compared to urban/suburban residents.
- Active community involvement positively correlates with quality of life, while regret about past actions negatively affects it.
- Personal wellbeing is the strongest predictor of successful aging, with rural residence and chronic illness acting as negative predictors.

## Abstract

What are the main findings?
Older adults in rural areas reported lower self-rated successful aging (SSAS) and personal wellbeing (PWI) than those in urban/suburban areas. PWI was the strongest positive predictor while rural residence and chronic illness were negative predictors.Active community involvement was positively associated with quality of life, whereas regret over missed opportunities or past actions had negative associations; no significant gender differences were observed in SSAS or PWI.

Older adults in rural areas reported lower self-rated successful aging (SSAS) and personal wellbeing (PWI) than those in urban/suburban areas. PWI was the strongest positive predictor while rural residence and chronic illness were negative predictors.

Active community involvement was positively associated with quality of life, whereas regret over missed opportunities or past actions had negative associations; no significant gender differences were observed in SSAS or PWI.

What are the implications of the main findings?
Promoting social engagement and psychosocial support could improve successful aging in rural areasConsidering wellbeing alongside health status and addressing rural disparities could improve aging programs.

Promoting social engagement and psychosocial support could improve successful aging in rural areas

Considering wellbeing alongside health status and addressing rural disparities could improve aging programs.

Background: Population aging has increased attention on the quality of life and successful aging of older adults. Objective: To examine urban–rural differences in subjective quality of life and self-rated successful aging, explore associations with psychosocial factors, and identify predictors of successful aging, including potential moderating effects of place of residence and chronic illness. Methods: A cross-sectional study was conducted among 403 adults aged ≥ 60 years in Eastern Croatia. Measures included a sociodemographic questionnaire, the Self-assessment of Successful Aging Scale (SSAS), and the Personal Wellbeing Index (PWI). Data were analyzed using nonparametric tests (Mann–Whitney U, Spearman’s correlation), linear regression, and moderation analyses. Significance was set at p < 0.05. Ethical approval was obtained (Class: 602-01/24-12/02; IRB: 2158/97-97-10-24-36). Results: Rural participants reported lower PWI scores (p = 0.005) and self-rated successful aging (p < 0.001) than urban participants. Active community involvement was positively associated with quality of life (Rho = 0.46; p < 0.001), whereas regret about missed opportunities and past actions was negatively associated (Rho = −0.20; p < 0.01). Regression analyses explained 48.3% of the variance in SSAS, with higher PWI scores being strongly associated with higher SSAS scores, and rural residence and chronic illness being associated with lower SSAS scores. Moderation analyses indicated that the association between PWI and SSAS was consistent across different environmental contexts and in the presence of illness. Conclusions: Older adults living in rural areas reported lower quality of life and self-rated successful aging compared with those in urban and suburban areas, with subjective wellbeing emerging as a key predictor. Promoting social engagement and addressing psychosocial barriers may enhance successful aging, particularly in rural populations. Findings suggest that social engagement and psychosocial support are associated with higher level of perceived successful aging, indicating potential areas for future community-based or healthcare interventions.