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Abstract
Objectives
The aim of this study is to examine the physical, psychological, and social factors influencing suicidal ideation among elderly Koreans.
Methods
Community Health Survey data obtained in 2013 were used for this study with a sample of 4367 elderly who reside in Gangwon province. The data were analyzed using the chi-square test and the logistic regression test to examine the relationship between suicidal ideation and other variables.
Results
Depression was the single most influential variable, both directly and indirectly increasing suicidal ideation. In particular, the increase of suicidal ideation among those with severe disease was affected by depression. Perceived poor social support and perceived poor health status were the two highest risk factors after depression, implying that subjective assessment of the elderly affects suicidal ideation significantly. Poor economic status and current smoking showed significantly higher risk for women only, although poor health, poor social support, and poor social activity commonly attributed to the risk of suicidal ideation in both genders.
Conclusion
This study suggests that suicidal ideation among the elderly should be approached in a multi-perspective way considering depression, social support, and physical health. It is notable that not only lack of resources but also perceived sense of poor social and physical well-being significantly affect suicidal ideation.
Figures and Tables
Table 2
Comparison between univariate models and two multivariate models regarding suicidal ideation
Model 1 : ORs were adjusted by age, sex, income, education, economic activity, marital status, living alone, social activity, perceived social support, alcohol, smoking, physical activity, severe disease, perceived health status. Model 2 : Depression was additionally adjusted. * : p<0.05, ** : p<0.001. CI : Confidence interval, OR : Odds ratio, SSQ6 : Social Support Questionnaire 6
Table 3
Comparison of gender difference by multivariate model with depression regarding suicidal ideation
Model 1 : ORs were adjusted by age, sex, income, education, economic activity, marital status, living alone, social activity, perceived social support, alcohol, smoking, physical activity, severe disease, perceived health status. Model 2 : Depression was additionally adjusted. * : p<0.05, ** : p<0.001. CI : Confidence interval, OR : Odds ratio, SSQ6 : Social Support Questionnaire 6
References
1. Organization for Economic Cooperation and Development. Health: key tables from OECD. Paris: OECD;2012.
2. Han SS, Kang SW, Yoo WK, Phee YG. A study of the determinants of suicidal ideation among the elderly in Korea. Health Soc Welf Rev. 2009; 29:192–212.
3. Van Orden K, Conwell Y. Suicides in late life. Curr Psychiatry Rep. 2011; 13:234–241.
4. Conwell Y, Thompson C. Suicidal behavior in elders. Psychiatr Clin North Am. 2008; 31:333–356.
5. Kim HS. The current trend of suicide and its prevention in life stages: focusing on the comparison of elderly and youth suicide. J Welf Aged. 2006; 34:271–292.
6. Mitchell PB, Harvey SB. Depression and the older medical patient--when and how to intervene. Maturitas. 2014; 79:153–159.
7. Juurlink DN, Herrmann N, Szalai JP, Kopp A, Redelmeier DA. Medical illness and the risk of suicide in the elderly. Arch Intern Med. 2004; 164:1179–1184.
8. Bergman Levy T, Barak Y, Sigler M, Aizenberg D. Suicide attempts and burden of physical illness among depressed elderly inpatients. Arch Gerontol Geriatr. 2011; 52:115–117.
9. Cheung G, Merry S, Sundram F. Medical examiner and coroner reports: uses and limitations in the epidemiology and prevention of late-life suicide. Int J Geriatr Psychiatry. 2015; 30:781–792.
10. Vanderhorst RK, McLaren S. Social relationships as predictors of depression and suicidal ideation in older adults. Aging Ment Health. 2005; 9:517–525.
11. Wu ZQ, Sun L, Sun YH, Zhang XJ, Tao FB, Cui GH. Correlation between loneliness and social relationship among empty nest elderly in Anhui rural area, China. Aging Ment Health. 2010; 14:108–112.
12. Golden J, Conroy RM, Bruce I, Denihan A, Greene E, Kirby M, et al. Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. Int J Geriatr Psychiatry. 2009; 24:694–700.
13. Rowe JL, Conwell Y, Schulberg HC, Bruce ML. Social support and suicidal ideation in older adults using home healthcare services. Am J Geriatr Psychiatry. 2006; 14:758–766.
14. Rana AQ, Qureshi AR, Mumtaz A, Abdullah I, Jesudasan A, Hafez KK, et al. Associations of pain and depression with marital status in patients diagnosed with Parkinson's disease. Acta Neurol Scand. 2015; 07. 3. [Epub]. DOI: 10.10.1111/ane.12454.
15. Ahn DH, Lee YJ, Jeong JH, Kim YR, Park JB. The effect of post-stroke depression on rehabilitation outcome and the impact of caregiver type as a factor of post-stroke depression. Ann Rehabil Med. 2015; 39:74–80.
16. Holvast F, Burger H, de Waal MM, van Marwijk HW, Comijs HC, Verhaak PF. Loneliness is associated with poor prognosis in late-life depression: Longitudinal analysis of the Netherlands study of depression in older persons. J Affect Disord. 2015; 185:1–7.
17. Voshaar RC, van der Veen DC, Kapur N, Hunt I, Williams A, Pachana NA. Suicide in patients suffering from late-life anxiety disorders; a comparison with younger patients. Int Psychogeriatr. 2015; 27:1197–1205.
18. Carney SS, Rich CL, Burke PA, Fowler RC. Suicide over 60: the San Diego study. J Am Geriatr Soc. 1994; 42:174–180.
19. Minayo MC, Cavalcante FG. Suicide attempts among the elderly: a review of the literature (2002/2013). Cien Saude Colet. 2015; 20:1751–1762.
20. Jeon HJ. Depression and suicide. J Korean Med Assoc. 2011; 54:370–375.
21. Medium and long term welfare policy for the aged in Gangwon province. Available from: http://www.prism.go.kr.
22. KCDC. Manuals for using Community Health Survey data 2013. 2015. p. 4–11.
23. Kim HS. A study on epistemology of Korean elder's suicidal thought. J Korean Gerontol Soc. 2002; 22:159–172.
24. Park EO, Lee HY. Factors Influencing Suicidal Ideation Among Korean Adults by Age: Results of the 2010-2011 Korean Health and Nutrition Examination Survey. Community Ment Health J. 2015; 04. 02. [Epub]. DOI: 10.10.1007/s10597-015-9863-7.
25. Ro J, Park J, Lee J, Jung H. Factors that affect suicidal attempt risk among korean elderly adults: a path analysis. J Prev Med Public Health. 2015; 48:28–37.
26. Serafini G, Pompili M, Innamorati M, Iacorossi G, Cuomo I, Della Vista M, et al. The impact of anxiety, depression, and suicidality on quality of life and functional status of patients with congestive heart failure and hypertension: an observational cross-sectional study. Prim Care Companion J Clin Psychiatry. 2010; 12:e1–e9.
27. Alexopoulos GS, Reynolds CF 3rd, Bruce ML, Katz IR, Raue PJ, Mulsant BH, et al. Reducing suicidal ideation and depression in older primary care patients: 24-month outcomes of the PROSPECT study. Am J Psychiatry. 2009; 166:882–890.
28. Alexopoulos GS, Bruce ML, Hull J, Sirey JA, Kakuma T. Clinical determinants of suicidal ideation and behavior in geriatric depression. Arch Gen Psychiatry. 1999; 56:1048–1053.
29. Lee SH. Comparative study on influencing factors of suicidal ideation according to sex in the elderly. J Korean Public Health Nurs. 2013; 27:500–512.
30. Kwon OG. A study on the determinants of suicide attempts among the elderly living alone?: focused on seniors in Seoul and Gyeonggi province. J Korean Home Manage Assoc. 2014; 32:207–219.
31. Han SS, Kang SW, Jeong SH. Experiences of depressive symptom and suicidal thinking between the elderly living alone and the elderly couples. Korean J Health Serv Manag. 2012; 6:29–38.
32. Kim YJ. Comparison of health habits, perceived stress, depression, and suicidal thinking by gender between elders living alone and those living with others. J Korean Acad Fundam Nurs. 2009; 16:333–344.
33. Yang OK, Ju SH. An exploratory study on the influencing factors to suicidal ideation among single-household elderly population. Ment Health Soc Work. 2011; 37:321–347.
34. Seo IK, Cho HC. Mediation effects of depression in the relationship between stress and suicidal ideation of the elderly: a comparative study on people who live alone and those who live with family. J Welf Aged. 2013; 61:135–162.
35. Gallant MP, Dorn GP. Gender and race differences in the predictors of daily health practices among older adults. Health Educ Res. 2001; 16:21–31.
36. Sung MH, Lim YM, Joo KS. The relationship between social support and loneliness in elderly women living alone. J Korean Public Health Nurs. 2011; 25:95–106.
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