Death Anxiety in Iranian Elderly: A Systematic Review and Meta-Analysis

Introduction: Aging is one of the most critical stages of human development that has its own characteristics and conditions. The most common issues are the mental health of the elderly. Because this period is full of all kinds of feelings of shortcomings and disabilities. Since anxiety is a multidimensional structure, it can be expected to affect many aspects of the elderly. The present study was conducted with the aim of systematic review and meta-analysis of published studies in the field of anxiety in Iranian elderly death. Method: This study reviews the studies related to the death anxiety of the Iranian elderly which were published in Persian between 1390 and 1398 (2012 to 2020). Using the keywords, death anxiety, elderly, the aged, searches were conducted in four internal databases, including Jihad Daneshgahi Scientific Database (SID), Iran Scientific Information and Documentation Research Institute (Irandoc), the countrychr('39')s Magazine Database (Magiran), the Iranian Medical Articles Bank (IDML), and CIVILICA, 61 titles were identified. After screening, 33 studies that met the entry and exit criteria were selected for the final review. We used Stata.14 and SPSS.22 software to perform a meta-analysis and descriptive data. Findings:The results showed that 40.35% of the participants were women and the rest were men. The mean and standard deviation of participantschr('39') age was reported to be 67.80±6.44. The results proved that the mean of death anxiety is higher in men than women. And the elderly living in nursing homes had the highest average death anxiety score of 11.8. Studies were categorized into three sections: comparison (three studies), intervention (eleven studies), and factors affecting the Iranian elderly’s death anxiety (eighteen studies). The results of the meta-analysis showed that there is no positive and significant relationship between spiritual therapy and reduction of death anxiety in the elderly (P > 0.05). In studies with spiritual and behavioral therapies, the amount of heterogeneity was significant and thus a positive and significant relationship was observed between the reductions of death anxiety by these treatments. Discussion: The results of the present study show that the average Iranian elderly’s death anxiety is low. The mean and standard deviation of death anxiety in Iranian elderly using the Templer questionnaire was 67.80±6.44 years. Religious beliefs, hopes for the intercession of imams and religious leaders, and hopes for deliverance from the hardships of this life seem to have contributed to the low death anxiety reported by Iranian seniors. Different results have been reported of the average death anxiety score of men and women. The difference in the findings of various studies might have resulted from the role of culture, religion, and dominant traditions of the society, the difference between the roles of men and women, and even the extent of the expression of fear and anxiety by men in the Iranian society. Most of the men show less tendency to express their emotions, including fear. Treatments and behavioral and spiritual interventions lead to a decrease in the elderly’s death anxiety through its influence on finding meaning in the elderly’s lives.