Aging, Mental Health and Ethnic Disparities: Understanding Geriatric Mental Health in Western Nepal

<b>Objective:</b> This study examined the prevalence of anxiety, low mental well-being, loneliness, depression, and insomnia among older adults in a district of western Nepal and identified factors associated with each of these conditions. <b>Methods:</b> A community-based cross-sectional study was conducted in Dang, Nepal from August 2023 to January 2024 among adults aged 60 years or older using purposive sampling technique (n = 814). Validated tools were used to assess each mental health conditions. Multivariate logistic regressions were conducted to identify factors associated with each condition. <b>Results:</b> Five percent of older adults had low mental well-being, 7.25% experienced loneliness, 14.13% showed signs of general anxiety disorder (GAD), 6.58% had depression, and 1.97% had insomnia. Older adults of <i>Dalit</i> ethnicity, those with chronic illnesses, and those with a family history of mental illness had a disproportionately higher odds of developing one or more mental health conditions compared with their counterparts. <b>Conclusion:</b> Mental health conditions such as anxiety, depression, sleep difficulties and loneliness, and low mental well-being were less prevalent in Dang compared to previous studies in Nepal, and were associated with caste, chronic illnesses, and family history of mental illnesses. These findings highlight the need for targeted mental health screening and culturally sensitive interventions-such as community-based programs that acknowledge caste-based stigma, strengthen family and social support systems, and integrate local language counseling- to address mental health needs of vulnerable older adults. Future nationally representative studies are needed to provide a broader understanding of mental health among older adults in Nepal.