Pain and the risk of social isolation and loneliness in older Chinese adults: Do gender, age, and education make a difference?

Objective: Pain has long been known to affect the health and well-being of older adults. However, no longitudinal study has examined the associations between pain, social isolation, and loneliness among older adults in China. This study aims to explore the relationships between pain and older Chinese adults' social isolation (family isolation and friend isolation) and loneliness, and whether these associations are moderated by gender, age, and education groups. Method: Data derived from the four waves of the China Longitudinal Aging Social Survey (CLASS, 2014-2020). The sample included 18,692 respondents (aged 60 years and older), and mixed-effects logistic models were used. Results: Pain is not significantly associated with family isolation. In contrast, pain increases the risk of friend isolation and loneliness. Regarding the moderating roles of gender, age, and education, the results show that the relationship between pain and friend isolation is stronger among older women compared to their male counterparts. The association between pain and the risk of friend isolation is stronger among young-old adults (60-69 years) than among their older counterparts (70 years and older). Conversely, the oldest old adults (80+ years) are more likely to experience loneliness combined with pain than their younger counterparts. In addition, the negative effect of pain on the risk of loneliness is stronger among the more educated than among the less educated older adults. Conclusions: The findings underscore the pivotal role of pain in shaping the social well-being of older adults, and highlight the need to consider sociodemographics and socioeconomic status when developing pain prevention and management strategies.