Niu Luyao, Qu Wenjie, Ying Xinyu, Cao Xin, Li Ruyu, Wang Xiyue, Gao Ruizhi, Chen Yuhua, Gao Yue-Xia
School of Public Health, Nantong University, Nantong, Jiangsu Province, China.
Xinglin College, Nantong University, Nantong, Jiangsu Province, China.
BMJ Open. 2025 Jan 14;15(1):e087204. doi: 10.1136/bmjopen-2024-087204.
The objective of this study is to explore the relationship between loneliness and socioeconomic status and social networks in older adults with activity of daily living (ADL) disabilities in China and investigate people who are more likely to feel lonely.
Cross-sectional study.
This study was conducted in six districts of Nantong, Jiangsu, China.
A total of 880 older adults with ADL disabilities who participated in long-term care insurance and had an ADL score of less than 40 were investigated by the convenient sampling method.
The UCLA Loneliness Scale (V.3) was used to assess loneliness.
Among 880 participants, the mean age was 80.64 years (SD 10.29) and 59.43% were females. The mean score of loneliness was 44.70 (SD=10.01), and the majority suffered from moderate (39.89%) or moderate to severe (40.11%) loneliness. Regression showed that lower loneliness was associated with being females (β=-1.534, 95% CI: -2.841 to -0.228), married (β=-3.554, 95% CI: -4.959 to -2.149), often communicating with children (β=-3.213, 95% CI: -4.519 to -1.908), having more than two friends (β=-5.373, 95% CI: -6.939 to -3.808) and receiving home-based rehabilitation once a day (β=-3.692, 95% CI: -5.642 to -1.743). Participants who lived in rural areas (β=1.926, 95% CI: 0.658 to 3.193) and were unemployed before retirement (β=4.691, 95% CI: 1.485 to 7.898) experienced higher loneliness for older adults with ADL disability. The classification and regression tree model showed fewer friends and communication with children sometimes, and living in rural areas felt more lonely.
The poorer socioeconomic status and social network among older adults with ADL disability perceived more loneliness. Attention should be paid to the loneliness status of such vulnerable people, particularly those with ADL disabilities living in rural areas and having fewer social networks.
本研究旨在探讨中国日常生活活动（ADL）能力受限的老年人中孤独感与社会经济地位及社会网络之间的关系，并调查更易感到孤独的人群。
横断面研究。
本研究在中国江苏省南通市的六个区开展。
采用便利抽样法，对880名参加长期护理保险且ADL评分低于40分的ADL能力受限老年人进行了调查。
采用加利福尼亚大学洛杉矶分校孤独感量表（第3版）评估孤独感。
880名参与者的平均年龄为80.64岁（标准差10.29），女性占59.43%。孤独感平均得分为44.70（标准差 = 10.01），大多数人患有中度（39.89%）或中度至重度（40.11%）孤独感。回归分析显示，孤独感较低与女性（β = -1.534，95%置信区间：-2.841至-0.228）、已婚（β = -3.554，95%置信区间：-4.959至-2.149）、经常与子女交流（β = -3.213，95%置信区间：-4.519至-1.908）、有两个以上朋友（β = -5.373，95%置信区间：-6.939至-3.808）以及每天接受一次居家康复治疗（β = -3.692，95%置信区间：-5.642至-1.743）有关。对于ADL能力受限的老年人，居住在农村地区（β = 1.926，95%置信区间：0.658至3.193）以及退休前失业（β = 4.691，95%置信区间：1.485至7.898）的人孤独感更高。分类回归树模型显示，朋友较少、有时与子女交流以及居住在农村地区的人感到更孤独。
ADL能力受限的老年人社会经济地位和社会网络较差，孤独感更强。应关注这类弱势群体的孤独状况，尤其是居住在农村地区且社会网络较少的ADL能力受限者。
