Background: Quality of life (QoL) is a key indicator of successful aging, yet remains underexplored among older adults in Nigeria.

Purpose: This study assessed QoL, its determinants, and challenges among geriatric patients attending the University of Benin Teaching Hospital, Benin City, Edo State.

Methods: A hospital-based cross-sectional survey was conducted among 150 patients aged ≥60 years using a structured interviewer-administered questionnaire adapted from the WHOQOL-BREF. Data were analyzed using descriptive statistics and multivariate logistic regression to identify predictors of QoL.

Results: Of 148 participants analyzed, 12.1% reported good QoL, 53.4% moderate, and 34.5% poor, with an overall moderate QoL (grand mean = 3.0). Environmental (3.2) and psychological (3.1) domains scored highest, while physical health (2.9) scored lowest. Key factors affecting QoL included chronic illness (3.6 ± 1.18), long-term disease management (3.7 ± 1.14), difficulty adhering to medications (3.8 ± 1.09), and physical limitations (3.4 ± 1.22). Multivariate analysis identified educational attainment (OR = 4.57; p = 0.005) and income level (OR = 5.25; p = 0.003) as significant predictors, while age, gender, and religion were not. Participants also reported challenges with health, mobility, finances, and medication adherence.

Conclusion: Geriatric patients experienced moderate QoL, with physical health most affected. Chronic illness, functional limitations, and poor medication adherence negatively influenced QoL, while higher education and income improved outcomes.

Implications: Nursing interventions targeting physical health, adherence to treatment, and socio-economic support are essential to enhance QoL among older adults.