Abstract
BACKGROUND: Current reports suggest a positive association between spirituality and quality of life (QoL) in elders. While most studies are qualitative studies and there has been little validation in quantitative studies using scales to measure spirituality. Hence, we aimed to study the effect of spirituality on mental health and QoL in older people residing in Kumejima Town in Japan. METHODS: An interview-based survey was conducted between September 2010 and 2011 on residents of Kumejima Town aged 65 years or older. This survey-based study employed the Spirituality Health Scale for the Elderly (SP Health Scale) alongside assessments of basic attributes (e.g., age, sex); physical, mental, social health, spirituality, and QoL. We conducted a causal structure model to explore causal relationships between these factors. RESULTS: Our study included 338 participants, including 72.5% female with an average age and standard deviation of 77.2 ± 6.4 years. Our analysis revealed a significant association between spiritual health and QoL even after accounting for the impact of physical and mental health, which challenged the conventional belief that QoL inevitably diminishes with age and declining health. These results suggest that enhancing spirituality may offer a means to prevent declines in QoL, fostering a positive outlook on life as individuals age. CONCLUSION: Our study suggests that improving spiritual health can enhance QoL, even in the presence of health challenges and aging. This novel perspective opens doors to redefining health as a state that coexists with illness, with spirituality serving as an integral component. A shift in our understanding of health that prioritizes spirituality, could benefit people of all ages, offering a more holistic approach to well-being that aligns with new medical technologies and evolving perceptions of health.