Health-related quality of life (HQL) among older adults is often neglected and underprioritized in developing countries and is further burdened during natural disasters, such as earthquakes. The main objective of this study was to explore the factors affecting HQL among older adults living in Lalitpur District of Nepal.

A total of 362 older adults participated in this study. Questionnaires were used to interview the respondents on various aspects, such as posttraumatic stress disorder (PTSD) and depression, functional ability, and social support. An analysis was made to explore the factors affecting HQL.

HQL scores ranged between 3.13 and 90.63. A majority of the respondents (215/362; 59.4%) scored ≤ 50, indicating poorer HQL. The multivariate analysis found the impact of the following factors on HQL: functional status (β = 0.295; P < 0.001), PTSD (β = −0.225; P < 0.001), chronic disease (β = −0.168; P < 0.001), social support (β = 0.120; P = 0.019), injury (β = −0.104; P = 0.024), age (β = −0.116; P < 0.001), and accessibility to resources.

Poor HQL of older adults was dependent on various factors. The disaster preparedness program in Nepal needs urgent attention to address the concerns of older adults by incorporating the findings from this study.