Introduction
Advances in health and treatment in the last few decades have led to an increase in the number of elderly people worldwide [2]. It is expected that the living environment of older adults is designed according to their needs and abilities so that they can feel satisfaction with the environment by having a sense of belonging to the place [8]. In this regard, the World Health Organization (WHO)prepared the main features of age-friendly cities in 8 domains. An age-friendly city increases the quality of life of the elderly by optimizing health, participation, and security [14]. Considering the change of Iran’s population pyramid towards old age and the influence of older people from all environmental conditions, as well as the effect of the indicators of an age-friendly city on increasing the sense of belonging and social participation of older adults, this study aims to determine the predictive role of the indicators of age-friendly cities in social belonging of older adults in Iran.

Methods
This is a descriptive-analytical study with a cross-sectional design that was conducted in 2022 on 300 elderly residents of Mohammadieh County in Qazvin Province. The participants were selected using a cluster sampling method. The criteria for entering the study were age 60 years or older, willingness to participate in the study, and the ability to communicate verbally. Those with severe physical diseases or diagnosed mental diseases (based on the self-report of the elderly) that prevented them from communicating and answering the questionnaire were excluded from the study. To collect data, a demographic checklist, an age-friendly city scale, and a social belonging scale were used. To determine the predictors of social belonging, univariate regression analysis was first used, and the variables that had a significant relationship with social belonging were entered into multivariate regression. The significance level was set at 0.05.

Results
The mean age of the participants was 67.55±6 years, ranged from 60 to 84 years. Most of them were male (n=157, 52.33%), married (n=216, 72%), illiterate (n=157, 52.33%) and with income less than the monthly expenses (n=177, 59%). According to the results in Table 1, marital status, educational level, and the safety/ease of transportation indicator of the age-friendly city scale were introduced as predictors of social belonging in the elderly.


Divorced older adults reported lower social belonging than married older adults (β=-0.150, P=0.006). Those with lower than high school education (β=0.170, P=0.003) and high school diploma (β=0.192, P=0.001) had higher social belongingness than illiterate seniors. The elderly who perceived the city’s safety and ease of transportation better (β=0.328, P<0.001), reported more social belonging.

Conclusion
The results of the present study showed that most of older adults in Mohammadieh County (65.3%) had high social belonging. Seniors who felt safe in the community and had easy access to public transportation had a higher sense of social belonging. The results can effectively help in proper planning in order to develop an age-friendly city. It is recommended to conduct more studies with a wider geographical scope and by observing the indicators of the age-friendly city and compare them with the results of studies conducted using the self-report method.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of Qazvin University of Medical Sciences (Code: IR.QUMS.REC.1401.002). After explaining the study objectives to the participants, and ensuring them of the confidentiality of their personal information, a written informed consent was obtained from all them.

Funding
This article was extracted from a master’s thesis of Samaneh Marofi, approved by the Department of Geriatric Nursing, School of Nursing and Midwifery, Qazvin University of Medical Sciences. This study was founded by Qazvin University of Medical Sciences.

Authors' contributions
Conceptualization, methodology, investigating, initial draft preparation, resources, editing and review: Samaneh Marofi, Fatemeh Mohammadi, and Seyedeh Ameneh Motalebi; Data analysis: Ahmad Alizadeh; Project administration: Fatemeh Mohammadi, and Seyedeh Ameneh Motalebi.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors would like to thank the Vice-Chancellor of Research of Qazvin University of Medical Sciences and seniors participated in this study.


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