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Results In our study samples, nearly 55.8% of the older adults were found to be suffering from DS. We found a significant association between DS and being female (aOR 1.25, 95% CI 0.89-2.09), Buddhism (aOR 1.95, 95% CI 1.58-2.42), Dalits (aOR 2.60, 95% CI 1.19-5.65), unemployed, low family income (aOR 1.77, 95% CI 1.07-2.92), smokers (aOR 1.49, 95% CI 1.01-2.2 and having chronic multi-morbid conditions (aOR 1.67, 95% CI 1.09-2.55). Conclusions The prevalence of DS was high among community-dwelling older adults in eastern Nepal. Our