Association between life satisfaction and health behaviours among older adults: a systematic review and meta-analysis

Abstract

Background Life satisfaction is a key indicator of quality of life among older adults. This systematic review and meta-analysis synthesised evidence on the association between life satisfaction and health behaviours such as smoking status, alcohol use, physical activity, diet/nutrition, and sleep among older adults aged 60 years and older.

Methods The review was conducted and reported following the PRISMA guidelines. We searched the electronic databases MEDLINE, APA PsycINFO, Web of Science, CINAHL, and Global Health from inception to 10 January 2025 for observational studies reporting an association between life satisfaction and health behaviours. Two independent reviewers completed article screening, data extraction, and risk of bias assessment. The result was summarised through a narrative synthesis, and meta-analysis was completed using CMA (version 4).

Results The 56 included studies were conducted across 22 countries between 1990 and 2025. The pooled mean age and female proportion were 70.59 years (95% CI: 68.98, 72.21) and 58.0% (95% CI: 55.1, 60.7), respectively. Narrative synthesis showed that most studies found quality sleep and/or 7–8 h of sleep (77.3%), a higher physical activity level (69.1%), and a regular intake of fruit and vegetables and/or a balanced diet regularly (52.9%) were significantly associated with higher life satisfaction. Smoking and alcohol use were associated with lower life satisfaction in 33.3% and 15.8% of the analysis, respectively. The meta-analysis showed that higher physical activity levels (r = 0.12, p = 0.003) were associated with higher life satisfaction. Only four studies on physical activity met the criteria for meta-analysis, and no studies on other health behaviours did.

Conclusions Quality sleep and/or 7–8 h of sleep, a higher physical activity level, and regularly eating fruit and vegetables and/or a balanced diet are associated with higher life satisfaction. The review provides evidence for policymakers, healthcare workers, caregivers, and society to encourage healthy behaviours that foster healthy ageing. Future studies should use standardised instruments to assess health behaviours and life satisfaction, facilitating cross-study comparisons and the meta-synthesis of research findings.