Relationship between socioeconomic status and social network with loneliness: a cross-sectional study of China older adults with activity of daily living disabilities

Objectives 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.Design Cross-sectional study.Setti...

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Main Authors: Xin Cao, Luyao Niu, Wenjie Qu, Xinyu Ying, Ruyu Li, Xiyue Wang, Ruizhi Gao, Yuhua Chen, Yue-Xia Gao
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/1/e087204.full
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author Xin Cao
Luyao Niu
Wenjie Qu
Xinyu Ying
Ruyu Li
Xiyue Wang
Ruizhi Gao
Yuhua Chen
Yue-Xia Gao
author_facet Xin Cao
Luyao Niu
Wenjie Qu
Xinyu Ying
Ruyu Li
Xiyue Wang
Ruizhi Gao
Yuhua Chen
Yue-Xia Gao
author_sort Xin Cao
collection DOAJ
description Objectives 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.Design Cross-sectional study.Setting This study was conducted in six districts of Nantong, Jiangsu, China.Participants 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.Primary outcome measures The UCLA Loneliness Scale (V.3) was used to assess loneliness.Results 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.Conclusions 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.
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spelling doaj-art-3a3af149283e4303a80e487105f248ee2025-01-15T05:35:09ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-087204Relationship between socioeconomic status and social network with loneliness: a cross-sectional study of China older adults with activity of daily living disabilitiesXin Cao0Luyao Niu1Wenjie Qu2Xinyu Ying3Ruyu Li4Xiyue Wang5Ruizhi Gao6Yuhua Chen7Yue-Xia Gao8School of Public Health, Nantong University, Nantong, Jiangsu Province, ChinaSchool of Public Health, Nantong University, Nantong, Jiangsu Province, ChinaSchool of Public Health, Nantong University, Nantong, Jiangsu Province, ChinaSchool of Public Health, Nantong University, Nantong, Jiangsu Province, ChinaSchool of Public Health, Nantong University, Nantong, Jiangsu Province, ChinaSchool of Public Health, Nantong University, Nantong, Jiangsu Province, ChinaXinglin College, Nantong University, Nantong, Jiangsu Province, ChinaNantong Health College of Jiangsu Province, Nantong City, Jiangsu Province, ChinaSchool of Public Health, Nantong University, Nantong, Jiangsu Province, ChinaObjectives 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.Design Cross-sectional study.Setting This study was conducted in six districts of Nantong, Jiangsu, China.Participants 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.Primary outcome measures The UCLA Loneliness Scale (V.3) was used to assess loneliness.Results 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.Conclusions 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.https://bmjopen.bmj.com/content/15/1/e087204.full
spellingShingle Xin Cao
Luyao Niu
Wenjie Qu
Xinyu Ying
Ruyu Li
Xiyue Wang
Ruizhi Gao
Yuhua Chen
Yue-Xia Gao
Relationship between socioeconomic status and social network with loneliness: a cross-sectional study of China older adults with activity of daily living disabilities
BMJ Open
title Relationship between socioeconomic status and social network with loneliness: a cross-sectional study of China older adults with activity of daily living disabilities
title_full Relationship between socioeconomic status and social network with loneliness: a cross-sectional study of China older adults with activity of daily living disabilities
title_fullStr Relationship between socioeconomic status and social network with loneliness: a cross-sectional study of China older adults with activity of daily living disabilities
title_full_unstemmed Relationship between socioeconomic status and social network with loneliness: a cross-sectional study of China older adults with activity of daily living disabilities
title_short Relationship between socioeconomic status and social network with loneliness: a cross-sectional study of China older adults with activity of daily living disabilities
title_sort relationship between socioeconomic status and social network with loneliness a cross sectional study of china older adults with activity of daily living disabilities
url https://bmjopen.bmj.com/content/15/1/e087204.full
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