Characteristics of the “young-old” and “old-old” community-dwelling suicidal Ideators: A longitudinal 6-month follow-up study

다국어 초록 (Multilingual Abstract)

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Despite heterogeneity of older people in suicidal behavior, research identifying characteristics by age groups is scarce. We examined baseline features of older community-dwelling suicidal ideators by dichotomized age groups and the 6-month trajectory of their suicidal ideation along with its related psychopathology. Predictors of suicidal ideation within each group were investigated.</P> <P><B>Methods</B></P> <P>Older community-dwelling suicidal ideators enrolled in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were subdivided into the “young-old (65–74 years)” and “old-old (≥75 years)” group. Baseline, 1-, and 6-month assessments were compared. Within each group, multiple regression analysis using rating scales (Patient Health Questionnaire-9, Beck Anxiety Inventory, Alcohol Use Disorders Identification Test, Stress Questionnaire for Korean National Health and Nutrition Examination Survey-Short Form, and Social Relationships Scale) was conducted to identify predictors of suicidal ideation measured with the intensity subscale of the Columbia-Suicide Severity Rating Scale. Two-way repeated-measures analysis of variance (RM-ANOVA) was used to compare changes in suicidal ideation, depression, anxiety between age groups over time, and one-way RM-ANOVA to examine changes within each age group.</P> <P><B>Results</B></P> <P>Among 29 “young-old” and 53 “old-old” ideators, the latter were less likely to be receiving psychiatric treatment (odds ratio [OR] = 4.065) and make suicide attempts (OR = 2.874), whereas the former revealed greater levels of anxiety and stress. Baseline depression and stress in the “young-old” group and the “old-old” group, respectively, predicted the intensity of suicidal ideation at both baseline and 1-month assessments. No significant age group x time interactions on suicidal ideation and depression were found. However, within each age group, both suicidal ideation and depression significantly decreased only during the first month with no further improvement.</P> <P><B>Conclusion</B></P> <P>We speculate cautiously that more attention may need to be paid to the “old-old” ideators in the evaluation of psychiatric issues and for referral to psychiatrists. To decrease suicidal ideation, tailored approaches involving proactive, timely management of depression in the “young-old” and interventions focusing on stress reduction in the “old-old,” would be helpful.</P> <P><B>Highlights</B></P> <P> <UL> <LI> “Young-old (65–74)” and “old-old (≥75)” suicidal ideators have different features. </LI> <LI> “Old-old” suicidal ideators need to receive more psychiatric attention. </LI> <LI> Higher depression predicts greater suicidal ideation in the “young-old”. </LI> <LI> Higher stress is associated with greater suicidal ideation in the “old-old”. </LI> <LI> Significant reductions in elderly suicidal ideation and depression occur initially. </LI> </UL> </P>