Life satisfaction among the elderly has become an important issue in geriatric care [12-14]. The prevailing literature shows that it is affected by various physical, emotional, social and mental conditions [11,35]. Iwatsubo and colleagues 
reported a significant relationship between life satisfaction and
physical disabilities, leisure-time activities, marital and mental
health status and family relationships amongst retired people in
France. The results of our study also indicate a significant
relationship between life satisfaction and involvement in regular
physical and leisure-time activities. We also observed significantly
lower life satisfaction scores in those with low incomes than in those
with moderate and high incomes. The overall mean LSI-A score of our
study group was 20.3 ± 5.9, which was lower than that (24.2 ± 4.4)
reported by Iwatsubo et al. .
It can be argued that the differing results from different countries
may be linked to differences in socio-cultural circumstances and
demographic profiles. McConatha et al. reported that studies regarding
life satisfaction of Turkish elderly population are few in number . Imamoglu and Imamoglu 
also compared Turkish respondents with those of a comparable Swedish
sample. The findings of their cross-cultural study reported that,
although Turks had more social contact with their relatives and
neighbors, they had more negative attitudes about aging, felt lonelier,
and had lower life satisfaction than Swedes. These authors also
speculated that a decrease in satisfaction with social contacts may
result in urban contexts, lowering life satisfaction for Turkish
However, in Turkey, Subasi and Hayran 
found higher LSI-A scores (mean: 25.2 ± 5.5) than ours, which may be
attributable to socio-cultural differences, vis-à-vis higher education
and income levels, of the participants in the two studies. It may
therefore be concluded that socioeconomic and educational variables are
important factors in measuring the life satisfaction of the elderly
both nationally  and internationally [39,40].
The mean LSI-A score for the physically active individuals in our
study group was significantly higher than for those who led
comparatively sedentary life styles (p = 0.01), a finding that is
consistent with several other reports [35,41,42].
A previous study showed that daily walks, callisthenic exercises and/or
Tai-Chi amongst nursing home residents were associated with higher life
satisfaction scores . Similarly, Subasi and Hayran 
reported higher life satisfaction scores for elderly people who take
part in regular recreational activities. The multivariate analysis of
our data showed that leisure-time activities and regular physical
activities were significant predictors of LSI-A scores. Thus, these
results suggest the importance of encouraging the residents of nursing
homes to take part in regular physical and/or leisure-time activities.
Regular physical activity as an important component of successful
aging produces significant health benefits: it improves the health and
functional status of the elderly  and also decreases the number of falls [20,21]. Approximately 30% of over-65s suffer at least one fall a year [20-23].
Elderly residents of nursing homes face a higher rate of falls because
of nursing home settings and impaired functional capacities [21,23].
Nonetheless, in our study, the annual rate of falls (21.8%) was lower
than others have reported. We believe that the low fall rate of our
study group may be related to the restriction of our study to those who
were ADL-independentand had sufficient cognitive functions.
Although life expectancy at birth is higher for females (74.4 years)
than males (69.2 years) in Turkey, and elderly females slightly
outnumber males in the population [3,44],
more males thanfemales were included in our study group. In Turkey,
approximately 65% of elderly living in the institutions is aged between
60 and 79 years . It has been pointed out that Turks are generally more unfavorable toward institutional living [4,37].
It has also been implied that there are significant cultural
differences between Turkey and western countries, which extend to
attitudes toward aging and older adults. Turkey can be said to be a
more collectivist culture. The studies indicated that older adults
still hold considerable prestige and are valued and respected in Turkey
Thus, only a relatively small percentage of the elderly population
prefers to live in institutions in Turkey compared to industrialized
western countries .
Generally speaking, most Turkish elderly either live alone in their
homes in close proximity to their children or together with their
married children .
However, Turkish males have more social network interactions than
Turkish females. Relative to males, females are more often in
relationships with their children, parents, and neighbors .
Compared to males, elderly females in particular are more frequently
invited to live with their children and are rarely left to live alone . Therefore, 60% of elderly people living in institutions in Turkey are male .
This might explain the higher proportion of males in our study,
indicating a different aspect of the cultural and social structure of
Acculturation is increasingly becoming an integral function of nurses and administrators in care organizations for elderly .
Therefore, the trends in Turkey in searching for alternative health
care services for elderly people are becoming an important issue,
similar to western countries.
Like any study, ours has some limitations. The first is the size and
selection of the sample. Since our sample was selected from amongst the
residents of a publicly owned institute in Istanbul, generalizing our
findings to the entire Turkish elderly population may be somewhat
tenuous. Also, our findings should be carefully interpreted in view of
the slightly lower internal consistency (Cronbach's Alpha = 0.66) of
the LSI-A in our study group.