Migrant-Local Differences in the Relationship Between Oral Health, Social Support, and Loneliness Among Older Adults in Weifang, China: Cross-Sectional Study.

Abstract

Background: 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.

Objective: 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.

Methods: 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.

Results: 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).

Conclusions: 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.