Migrant-local Difference on the Relationship between Oral Health, Social Support, and Loneliness among the Older Adults in Weifang, China: A Cross-sectional Study (Preprint)

BACKGROUND Increased ageing and accelerated urbanization have led to the migration of older adults in China. The migration older adults (MOA) suffered 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 Objective: This study aimed to explore the association between oral health, social support and loneliness among the Chinese older adults, as well as the migrant-local difference on the above relationship. METHODS Methods: Multistage cluster random sampling was used to enroll a total of 1205 participants, including 613 migrant older adults and 592 local older adults (LOA). Loneliness was assessed by six items short-form UCLA Loneliness Scale (ULS-6); oral health was measured via the Chinese version Geriatric Oral Health Assessment Index (GOHAI); social support was evaluated by Social Support Rating Scale (SSRS). Descriptive analysis, chi-square test, and t test were conducted. Multi-group structural equation modeling (SEM) was employed to clarify the migrant-local difference on the association between oral health, social support and loneliness among the MOA and LOA. RESULTS Results: The mean score of loneliness was 8.58 ± 3.032 for the MOA and 8.00 ± 2.790 for the LOA. Oral health and social support were found to be negatively related to loneliness among the MOA and LOA, the standardized direct effect for the MOA were -0.168 and -0.444, for the LOA were -0.243 and -0.392, respectively. Oral health generated a direct positive effect on social support, and the direct effect was 0.186 for the MOA and 0.247 for the LOA. CONCLUSIONS Conclusions: The loneliness was fairly low among the old adults in Weifang, China, while the MOA showed higher loneliness than LOA. Oral health had both direct and indirect negative effects on loneliness among the MOA and LOA, with a slightly stronger effect on LOA than MOA. Social support was found to be negatively associated with loneliness for both MOA and LOA, while the association was stronger among the MOA than LOA. Oral health exerted significantly positive effect on social support for both MOA and LOA, while on the correlation was stronger among the LOA than MOA. Measures should be taken by the government, society and families to increase social support, improve oral health, and further reduce the loneliness among the MOA and LOA.