Liu Hui, Wang Jieru, Chen Rui, Xu Xixing, Pang Mingli, Feng Kaiyuan, Li Bingsong, Li Qinling, Qin Ziwei, Yan Shuyi, Ibn Ziyat Nabila, Kong Fanlei
Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, China, 86 19966534511.
NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
JMIR Public Health Surveill. 2025 Mar 13;11:e66061. doi: 10.2196/66061.
Increased aging and accelerated urbanization have led to the migration of older adults within China. Migrant older adults (MOAs) may experience physical and psychological discomfort in influx cities, and they are a vulnerable group that has emerged in the course of fast urbanization. Previous studies have confirmed the association between oral health and loneliness as well as the relationship between social support and loneliness; however, no research has been done to clarify the underlying mechanisms and the migrant-local difference between oral health, social support, and loneliness.
This study aimed to test the association between oral health, social support, and loneliness among Chinese older adults, as well as the migrant-local difference on the above relationship.
Multistage cluster random sampling was used to enroll a total of 1205 participants, including 613 MOAs and 592 local older adults (LOAs). Loneliness was assessed by the 6-item short-form UCLA Loneliness Scale; oral health was measured via the Chinese version Geriatric Oral Health Assessment Index (GOHAI); social support was evaluated by the Social Support Rating Scale (SSRS). Descriptive analysis, χ2 tests, and t tests were conducted. Multigroup structural equation modeling (SEM) was employed to clarify the migrant-local difference on the association between oral health, social support, and loneliness among MOAs and LOAs.
The mean score of loneliness was 8.58 (SD 3.032) for MOAs and 8.00 (SD 2.790) for LOAs. Oral health and social support were found to be negatively related to loneliness among MOAs and LOAs; the standardized direct effects for MOAs were -0.168 and -0.444 (P<.001), and they were -0.243 and -0.392 (P<.001) for LOAs, respectively. Oral health generated a direct positive effect on social support, and the direct effect was 0.186 for MOAs (P<.001) and 0.247 for LOAs (P<.001).
Loneliness was fairly low among older adults in Weifang, China, while MOAs showed higher loneliness than LOAs. Oral health had both direct and indirect negative effects on loneliness among MOAs and LOAs, with no significant path differences between MOAs and LOAs. Social support was found to be negatively associated with loneliness for both MOA and LOA, while the association was stronger among MOAs than LOAs. Oral health exerted a significantly positive effect on social support for both MOAs and LOAs, while no significant difference existed between them. Measures should be taken by the government, society, and families to increase social support, improve oral health, and further reduce loneliness among MOAs and LOAs.
老龄化加剧和城市化加速促使中国老年人迁移。流动老年人在流入城市可能会经历身体和心理不适，他们是快速城市化进程中出现的弱势群体。以往研究证实了口腔健康与孤独感之间的关联以及社会支持与孤独感之间的关系；然而，尚未有研究阐明口腔健康、社会支持和孤独感之间的潜在机制以及流动老年人与本地老年人之间的差异。
本研究旨在检验中国老年人口腔健康、社会支持和孤独感之间的关联，以及上述关系在流动老年人与本地老年人之间的差异。
采用多阶段整群随机抽样法共纳入1205名参与者，其中包括613名流动老年人和592名本地老年人。孤独感采用6项简版UCLA孤独量表进行评估；口腔健康通过中文版老年人口腔健康评估指数（GOHAI）进行测量；社会支持采用社会支持评定量表（SSRS）进行评价。进行描述性分析、χ²检验和t检验。采用多组结构方程模型（SEM）阐明流动老年人和本地老年人在口腔健康、社会支持和孤独感之间关联上的差异。
流动老年人孤独感平均得分为8.58（标准差3.032），本地老年人为8.00（标准差2.790）。发现口腔健康和社会支持与流动老年人和本地老年人的孤独感均呈负相关；流动老年人的标准化直接效应分别为-0.168和-0.444（P<0.001），本地老年人分别为-0.243和-0.392（P<0.001）。口腔健康对社会支持产生直接正向效应，流动老年人的直接效应为0.186（P<0.001），本地老年人为0.247（P<0.001）。
中国潍坊地区老年人孤独感水平较低，而流动老年人的孤独感高于本地老年人。口腔健康对流动老年人和本地老年人的孤独感均有直接和间接的负向影响，流动老年人与本地老年人之间无显著路径差异。社会支持与流动老年人和本地老年人的孤独感均呈负相关，且流动老年人中的关联更强。口腔健康对流动老年人和本地老年人的社会支持均有显著正向影响，二者之间无显著差异。政府、社会和家庭应采取措施增加社会支持、改善口腔健康，进一步降低流动老年人和本地老年人的孤独感。
