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This study aims to identify factors that determine spiritual well-being in older adults and their relationship with geriatric assessment parameters.

July 3, 2026Open Access

Determinants of spiritual well-being in older adults: the role of geriatric assessment domains and religious coping

Key Points

This study aims to identify factors that determine spiritual well-being in older adults and their relationship with geriatric assessment parameters.
Cross-sectional study with 199 older patients (≥ 65 years) at a geriatrics clinic from January 2022 to December 2023.
Spiritual well-being measured using the FACIT-Sp-12; geriatric assessment covered multiple health domains including depressive symptoms and religious coping assessed with the Religious Coping Scale for Muslims.
Data analyzed using multiple linear regression and mediation analysis for urinary incontinence and spiritual well-being.
Depressive symptoms correlated strongly with lower spiritual well-being (rho = -0.40, p < 0.001).
Only depressive symptoms (β = -0.38) and religious coping (β = 0.26) were significant in the final model (model R2 = 0.36).
Mediation analysis showed that 41% of the relationship between urinary incontinence and spiritual well-being was mediated by depressive symptoms.

Abstract

Spiritual well-being is a vital component of aging, yet its relationship with standard geriatric markers remains unclear. This study aimed to identify determinants of spiritual well-being among older outpatients by examining its association with Comprehensive Geriatric Assessment (CGA) parameters. In this cross-sectional study, we included 199 patients aged ≥ 65 years admitted to a geriatrics clinic between January 2022 and December 2023. The FACIT-Sp-12 measured spiritual well-being. Comprehensive geriatric assessment parameters included functional status, cognitive function, nutritional status, depressive symptoms, urinary incontinence, falls, polypharmacy and subjective sleep complaints. Religious coping was evaluated using the Religious Coping Scale for Muslims. Data were analyzed using robust multiple linear regression and cross-sectional mediation analysis to identify independent correlates and to assess whether depressive symptoms statistically accounted for part of the urinary incontinence–spiritual well-being association. Participants averaged 76.5 ± 6.6 years; 66.3% were women. Depressive symptom scores correlated most strongly with lower spiritual well-being (rho = -0.40, p < 0.001). Better daily function (Lawton rho = 0.26; Katz rho = 0.23) and greater religious coping (rho = 0.29) accompanied higher scores. When we controlled for confounders, only depressive symptoms (β = -0.38) and religious coping (β = 0.26) remained significant (model R 2 = 0.36). Physical function did not remain independently associated once depressive symptoms entered the model. In mediation testing, 41% of the association between urinary incontinence and spiritual well-being was statistically accounted for by depressive symptoms. Depressive symptoms appear to be the dominant negative correlate of spiritual well-being in geriatric outpatients, while religious coping shows an independent positive link. The attenuation of functional measures after accounting for depressive symptoms may align with gerotranscendence theory or simply reflect ceiling effects in this functionally well-preserved outpatient sample. Either way, these data underscore the relevance of addressing depressive symptoms and acknowledging religious resources when caring for older adults.

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