Introduction
In the coming years, the elderly will allocate a large part of the population of developing countries, including Iran and Iraq. Increasing knowledge in the field of the condition and factors related to a healthy lifestyle is vital. A healthy lifestyle is a complex set of health-related activities, such as physical activity, nutrition, stress control, interpersonal relationships, and compliance with safety principles, which are influenced by the difference in societies and socio-economic processes affect it. Searching for the predictors of a healthy lifestyle and knowing the intensity of their impact is crucial because with a correct prediction of the existing reality, it is possible to plan and foresight to prioritize more effective interventions. This study was conducted to determine and compare the status of a healthy lifestyle and its predictive factors in the elderly living in Iran and Iraq.
Methods 
This descriptive-analytical study was conducted on 800 elderly people over 60 years old who were referred to the health centers of Najaf City, Iraq and Mashhad City, Iran in 2021. The research units were selected by cluster probability sampling. In this way, 2 comprehensive health service centers were randomly selected from each selected health center. Then, among the available files, the elderly people who met the inclusion criteria in the centers, depending on the number of people covered and the total sample size, were selected randomly and by lottery method and the study was explained to them through a telephone call and were invited to participate in the study. Due to the spread of COVID-19 and to reduce the time spent by the elderly in the comprehensive health services center, the research questionnaires were sent to the elderly people or one of their relatives via WhatsApp so that they are familiar with the questions from the previous study and be less present in the center to complete the questionnaires. The time required to complete the questionnaires was between 20 and 30 minutes. The data was collected using the demographic characteristics form, the healthy lifestyle questionnaire of the elderly, and the questionnaire of possible predictive factors of a healthy lifestyle. For the participants in Najaf, the questionnaires were translated into Arabic. SPSS software version 23 was used for data analysis. To decide on the use of the appropriate test to compare demographic variables and the main research variables between the two countries, first, the normality of the distribution of quantitative variables was checked using histograms and normal quantile-quantile plots (QQ-plot), based on the results, no serious deviation was observed from the normal distribution in any of the quantitative variables. Chi-square, Mann-Whitney, and independent t statistical tests were used to compare the studied variables in the two countries, and a regression test was used to determine the predictors of lifestyle (significance level less than 0.05). 
Results
 The age of the elderly in Iran and Iraq was 66.89 ± 6.68 and 66.42 ± 5.23, respectively who were in the age range of 60 to 101 years. The majority of research units in Iran were elderly women at about 54% and in Iraq, elderly men at 62%. About 75% of the Iranian elderly and 59% of the Iraqi elderly had an average lifestyle. The mean and standard deviation of total lifestyle scores in Iran and Iraq were 145.75 ± 14.97 and 152.29 ± 13.46, respectively, and the independent t test showed a significant difference (P < 0.001). In the study of healthy lifestyle areas, the Iranian elderly had higher mean scores only in the field of sports and entertainment (P < 0.001), while the mean scores in the areas of prevention, healthy nutrition, and stress management were higher in the Iraqi elderly (P < 0.001). The variable of interpersonal and social relations between the elderly of Iraq and Iran had no significant difference (P < 0.05). The multiple linear regression test showed that the variables of age, self-assessment of health, drug abuse, satisfaction with income, job satisfaction, marriage and companions in Iranian elderly people, and the variables of age, sex, self-assessment of health, smoking, satisfaction with income and companions in Iraqi elderly people have a significant relationship with a healthy lifestyle (P<0.05). Based on the size of the reported effects in the model related to Iran, the drug variable has the highest predictive role. But in Iraq, the highest impact is related to income satisfaction. According to the adjusted determination coefficient of the regression model, the predictive factors predicted 25% in Iran and 37% in Iraq of the healthy lifestyle score.
Discussion
 The findings of the research showed that the score of the healthy lifestyle of the elderly in the two countries of Iraq and Iran is average and a significant but insignificant difference exists between the two countries. It is recommended to improve the level of healthy lifestyle of the elderly in both countries from the current situation to the optimal level. To achieve this goal, health officials should pay more attention to the crucial factors affecting the healthy lifestyle of the elderly, especially drug abuse and income satisfaction in Iran and Iraq, respectively.

Ethical Considerations
Compliance with ethical guidelines
This article is taken from the master's thesis (Code : 991493). In order to comply with ethical considerations, in addition to completing the informed consent form by the participants in the research, they were assured about the confidentiality of the information, and accordingly, a code was given to each of the questionnaires (Code: IR.MUMS.NURSE.REC.1399.107). 

Funding
Research Vice-Chancellor of Mashhad University of Medical Sciences was the financial sponsor of this research (Code: 991493).

Authors' contributions
Conceptualization: Mahmoud Bakhshi, Akram Ghanbari Moghaddam; Methodology: Mahmoud Bakhshi, Sadegh Mohsen Al-Gimavi, Akram Ghanbari Moghaddam; Data collection: Mahmoud Bakhshi, Sadegh Mohsen Al-Gimavi, Hasanain Al-Khalidi; Research and review, writing and editing of the article: All authors; Data analysis: Mahmoud Bakhshi, Vahid Ghavami.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
This article is the result of a master’s thesis with tracking code 991493. The authors of the article thank the research vice-chancellor of Mashhad University of Medical Sciences for the financial support of this research, the people participating in the research, and all the personnel of the studied health centers.

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