1. Introduction
Today, the issue of the well-being of the elderly has become a severe policy-making challenge and a key subject of research. The complexity, multidimensionality, and multilevel nature of the concept of well-being have led to numerous indexations in the objective and subjective dimensions and at the micro and macro levels. In recent years, the Global Age Watch Index has been designed and introduced to describe and measure the well-being of the elderly. The purpose of this article is to assess and measure the well-being status of the Iranian elderly and determine Iran’s position in comparison with other countries, as well as to calculate the Age Watch Index for different provinces of Iran and its relationship with human development index.
2. Methods
The assessment of the well-being status of Iranian elderly at national and provincial levels for 2016 was performed within the methodological framework of the Global AgeWatch Index and the use of secondary analysis of various data sources in SPSS v. 25 and Excel software environments. This indicator in four dimensions of income security, health status, capability/competency, and enabling environment, tries to provide a holistic view of the well-being of the elderly.
The construction and measurement of the four dimensions and the Overall AgeWatch Index at the national and provincial levels were done by adapting the methodology of the report of the Global AgeWatch Index in five stages: First, all component values ​​were presented as positive values. Second, the value of each component was calculated and presented in its normalized value (between 0 and 100). Third, the geometric mean of the component values ​​(concerning different weights) within each dimension was calculated. Fourth, the Overall AgeWatch Index was obtained based on the geometric mean of normalized values ​​with the same weight in all four dimensions of income security, health, capacity and competency, and enabling environment. Fifth, finally, based on the scores in each dimension and the combined AgeWatch Index score, Iran’s position was compared with other countries, and also at the provincial level, 31 provinces were compared and ranked.
3. Results
Comparison of Iran’s Overall AgeWatch Index and its different dimensions with 96 countries of the world (calculated in the 2015 report of the Age Watch Index) showed that Iran is ranked 64th in the Overall AgeWatch Index. It is also ranked 65th in income security, 43rd in health status, 88th in capability and competency, and 49th in enabling environment among 97 countries. Therefore, Iran has the best rank and position in terms of health status and the worst in terms of competency and capability of the elderly.
In addition, the results indicate significant provincial differences in the AgeWatch Index and its various dimensions, especially the two dimensions of income security and health status. The range of scores in terms of income security of the elderly ranged from 4% in Sistan and Baluchestan province to 86% in Tehran province. The health status of the elderly has fluctuated from 10% in South Khorasan to about 90% in Tehran province. The range of scores of the capacity and competency of the elderly ranged from 13% in Ilam province to 48% in Tehran province. Finally, the enabling environment dimension scores varied from 58% in Khuzestan and Kermanshah provinces to 80% in Semnan. Therefore, the results indicate significant provincial differences in different dimensions of the AgeWatch Index, especially income security and the health status of the elderly. The AgeWatch Index scores ranged from 6.5 in Sistan and Baluchestan provinces to 77.9 in Tehran. In general, the provinces of Tehran, Semnan, and Fars, respectively, are in the first to third ranks, and in contrast, the provinces of South Khorasan, Ilam and Sistan, and Baluchestan, respectively, are in the last ranks and positions of the index of the well-being of the elderly (Figure 1).



Developmental differences strongly influence regional differences in the AgeWatch Index in Iran. The study of this issue showed a positive and strong correlation (r=0.726) between these two indicators of human development and the Overall AgeWatch Index in the provinces of Iran. Therefore, with increasing human development index, the score of the AgeWatch Index increases. Accordingly, provinces with a high level of human development have a higher score on the AgeWatch Index, and in contrast, provinces with a low score of the AgeWatch Index are among the provinces with a low level of human development (Figure 2).



4. Discussion
Well-being makes sense as a pleasant situation for the elderly concerning the social, economic, political, and environmental context, and its mental and objective dimensions are interrelated. Inequality in the elderly well-being is felt in the provinces of Iran. Older people have many concerns about financial security and are concerned about sinking into poverty as they age, access to health care and medical care, adequate housing, age discrimination, loneliness, and feelings of futility. For this reason, it is necessary to formulate policies based on accurate and reliable information to address the problems of the elderly population and improve their quality of life. In addition to paying attention to economic security and income, it is also important to pay attention to the mental dimension of well-being and the feeling of happiness of the elderly. Although life expectancy has increased in Iran, it should be noted that increasing life expectancy should be accompanied by healthy living and a sense of purpose and meaning in life. Older people with high psychological well-being feel better motivated and are more likely to seek objective living standards.
Ethical Considerations
Compliance with ethical guidelines
This study has received financial support from Saba Pension Strategies Institute (Code: 10.1343)
Funding
This study has received financial support from Saba Pension Strategies Institute.
Authors' contributions
Conceptualization and methodology: Nasibeh Zanjari and Rasoul Sadeghi; Formal analysis: Rasoul Sadeghi; Investigation, resources, and draft preparation: Nasibeh Zanjari;Supervision; Project administration: Nasibeh Zanjari.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgments
Authors would like to thank the Saba Pension Strategies Institute for financial support of this project, the Statistical Center of Iran and Statistical Research and Training Center for providing the data, Saba Pension Strategies Institute for support this project, and Dr. Zahed Asadi for valuable comments and suggestions.