Introduction
The aging process involves changes, such as children’s independence, spousal death, retirement, and reduced social connections, which may contribute to loneliness in older adults [6]. Migration is a key factor in both population aging and elderly loneliness [7] and often leads young people to relocate from less developed to more developed areas for employment or better living conditions [8]. This can result in physical separation and diminished contact between older parents and their children [7]. Since children are a significant source of happiness and mental well-being for the elderly [10], the migration of adult children raises questions about their impact on older adults’ social support, loneliness, and quality of life. However, due to the novelty of this issue, few studies have examined elderly individuals with immigrant children. Thus, this study aimed to determine the relationship between quality of life, loneliness, and perceived social support in older adults with immigrant children.

Methods & Materials
This cross-sectional study assessed 200 participants above 60 years with immigrant children referred to the vaccination department of the Pasteur Institute of Iran. The inclusion criteria were informed consent, age ≥60 years, adequate literacy to complete the questionnaire, and a minimum of 3 months since the child(ren)’s migration; Exclusion criteria included incomplete questionnaire responses and the presence of cognitive impairments. Data were collected using demographic characteristics checklist, the loneliness questionnaire (UCLA), the multidimensional scale of perceived social support (MSPSS), and the SF-12 quality of life questionnaire. The validity and reliability of the Persian version of all tools had been confirmed in previous studies. For data analysis, descriptive statistics (frequency and percentage for qualitative variables and Mean±SD for quantitative variables) were used to describe demographic characteristics and main study variables. Inferential statistics (Spearman’s correlation coefficient and multiple regression analysis using the Enter method) were employed to examine relationships between quantitative variables and differences among groups. All collected data were analyzed using SPSS software, version 24 (α= 0.05). 

Results
This study included 200 older adults with a mean age of 66.84 ± 5.27 years, comprising 56.5% female (n=113) and 43.5% male (n=87). Regarding marital status, 164 participants (82%) were married, 28(14%) were widowed, and 8(4%) were divorced. Educational backgrounds varied: 124(62%) held university degrees, 64(32%) had high school diplomas, 9(4.5%) completed middle school, and 3(1.5%) possessed basic literacy. Employment status indicated that 126(63%) were retirees, 55(27.5%) were homemakers, 18(9%) were employed, and 1(0.5%) was disabled.
The total quality of life score indicates that the participants had a desirable quality of life. The perceived social support score among study participants was 49, within a possible range of 12 to 60, where higher scores signify greater social support. Loneliness levels indicated that participants generally fell within the mild loneliness category. 
Analysis revealed significant positive correlations between total quality of life scores and perceived social support (rs= 0.399, P<0.001). Conversely, significant negative correlations were found between quality of life and loneliness (rs=-0.572, P<0.001). Perceived social support scores also showed a significant inverse relationship with loneliness (rs=-0.569, P<0.001) (Table 1). 


Multiple regression analysis showed that loneliness was able to explain changes in overall perception of health (β=-0.02, P<0.001), physical function (β=-0.03, P<0.001), emotional problems (β=-0.03, P<0.001), physical pain (β=-0.04, P<0.001), social function (β=-0.05, P<0.001), vitality and vital energy (β=-0.06, P<0.001), and mental health (β=-0.11, P<0.001). However, perceived social support was not able to explain changes in quality of life dimensions (P>0.05).

Conclusion
This study investigated the relationship between quality of life, loneliness, and perceived social support among older adults with migrant children. participants maintained a good quality of life, experienced mild loneliness, and demonstrated moderate levels of perceived social support. The results demonstrated that loneliness reduces quality of life in this population. The study highlights the crucial need for families, communities, and policymakers to strengthen social support systems for older adults. Given the inevitability of children’s migration, concerted efforts should focus on establishing and maintaining robust social networks to mitigate the negative impacts on seniors’ quality of life. Such measures can effectively reduce loneliness and its adverse consequences while improving overall well-being in older adults. 

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of Iran University of Medical Sciences, Tehran, Iran (Code: IR.IUMS.REC.1403.206). The researchers explained the study’s goals. They assured participants that their personal information would be confidential. All participants signed the consent form before questionnaire administration. 

Funding
This article was a extracted from the master's thesis Elham Shareh, approved by the in in the Geriatric Health Department of Iran University of Medical Sciences and Health Services. This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Authors' contributions
Conceptualization, methodology, validation, analysis, research and review, sources, editing and finalization of the manuscript, supervision, project management, visualization: all authors; sampling and drafting: Elham Shareh.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgments
We sincerely thank and appreciate all participants who generously contributed their time and cooperation with utmost patience. 


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