The relationship between oral health and active aging among the elderly in rural China: the chain mediating effect of intergenerational support and social isolation

Oral health is essential to overall health and significantly impacts active aging in older adults. However, the underlying mechanisms linking oral health to active aging are not yet clear, especially among rural older adults, where this relationship warrants further exploration. This study focuses on older adults in rural China, examining whether intergenerational support and social isolation mediate the relationship between oral health and active aging. Between July and August 2024, a total of 1276 older adults were recruited from rural areas of Anhui Province, China, using the convenience sampling method. Data were collected using a general information questionnaire, the Geriatric Oral Health Assessment Index (GOHAI), the Intergenerational Support Scale (ISS), the Lubben Social Network Scale (LSNS-6), and the Active Aging Scale (AAS). A chain mediation analysis was conducted using SPSS PROCESS 4.1 (Model 6). The generalizability of the model was further examined across different age groups. The mediation analysis indicated that oral health not only has a direct positive effect on active aging (effect = 0.291, 95% CI: LL = 0.175, UL = 0.406), but also indirectly influences the level of active aging through three significant mediating pathways: the independent mediating effect of intergenerational support (effect = 0.066, 95% CI: LL = 0.042, UL = 0.096), the independent mediating effect of social isolation (effect = 0.049, 95% CI: LL = 0.005, UL = 0.093), and the chain mediating effect between intergenerational support and social isolation (effect = 0.023, 95% CI: LL = 0.013, UL = 0.034). Age subgroup analyses revealed that this chain mediation model was most robust in the 70–79 age group. Oral health directly or indirectly affects active aging through intergenerational support and social isolation. However, the strength of these pathways varies across age groups, suggesting that improving oral health issues and enhancing intergenerational support and social networks can synergistically elevate the level of active aging among rural older adults, with particular emphasis on the 70–79 age cohort. Not applicable.