J Korean Acad Nurs.  2013 Apr;43(2):296-303. 10.4040/jkan.2013.43.2.296.

Depression and Suicidal Ideation in Elders with Dementia

• Kim JP
• Hyun MY

• KMID: 1739493
• DOI: http://doi.org/10.4040/jkan.2013.43.2.296

Abstract

PURPOSE
The purpose of this study was to investigate the prevalence of depression and suicidal ideation in elders with dementia and to identify factors influencing their suicidal ideation.
METHODS
A descriptive and cross-sectional study was conducted from February to March, 2011. The participants were 298 older adults whose MMSE-KC score was 15 to 23. Collected Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression.
RESULTS
According to the Geriatric Depression Scale (GDS) classification criteria, 86.2% of the elders in this study exhibited depression (GDS=5), and 31.5% manifested severe depression. The mean score of suicidal ideation was 5.70 (range 0-20). The risk factors for suicidal ideation were depression, suicidal attempt experience, present location for care, and activities of daily living.
CONCLUSION
The results of this study can be utilized in the development of suicide prevention programs for older adults with dementia. In particular, depression should be screened and managed to reduce suicidal ideation of older adults with dementia.

Keyword

Dementia; Depression; Suicidal ideation

MeSH Terms

Activities of Daily Living
Aged
Aged, 80 and over
Analysis of Variance
Cross-Sectional Studies
Dementia/*psychology
Depression/*epidemiology
Female
Humans
Male
Questionnaires
Risk Factors
*Suicidal Ideation
Suicide, Attempted

Reference

1. Awata S, Seki T, Koizumi Y, Sato S, Hozawa A, Omori K, et al. Factors associated with suicidal ideation in an elderly urban Japanese population: A community-based, cross-sectional study. Psychiatry Clin Neurosci. 2005. 59(3):327–336. http://dx.doi.org/10.1111/j.1440-1819.2005.01378.x.

2. Chiu HF, Lam LC, Pang AH, Leung CM, Wong CK. Attempted suicide by Chinese elderly in Hong Kong. Gen Hosp Psychiatry. 1996. 18(6):444–447.

3. Choi I. Factors affecting the suicide intention of the elderly. 2008. Seoul: Sahmyook University;Unpublished master's thesis.

4. Choi SH, Choi YH, Kim HS. Suicidal ideation and associated factors of the elderly in urban areas. J Korean Acad Community Health Nurs. 2008. 19(1):5–12.

5. Erlangsen A, Zarit SH, Conwell Y. Hospital-diagnosed dementia and suicide: A longitudinal study using prospective, nationwide register data. Am J Geriatr Psychiatry. 2008. 16(3):220–228. http://dx.doi.org/10.1097/JGP.0b013e3181602a12.

6. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G^*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009. 41(4):1149–1160. http://dx.doi.org/10.3758/brm.41.4.1149http://dx.doi.org/10.3758/brm.41.4.1149.

7. Ha J. The early stage of dementia patients' shrinking experiences. J Korean Gerontol Nurs. 2006. 8(1):58–63.

8. Harlow LL, Newcomb MD, Bentler PM. Depression, self-derogation, substance use, and suicide ideation: Lack of purpose in life as a mediational factor. J Clin Psychol. 1986. 42(1):5–21.

9. Haw C, Harwood D, Hawton K. Dementia and suicidal behavior: A review of the literature. Int Psychogeriatr. 2009. 21(3):440–453. http://dx.doi.org/10.1017/s1041610209009065.

10. Hong SH. A comparative study of social support network among the elderly groups with and without dementia or depression. J Korea Gerontol Soc. 1999. 19(2):113–128.

11. Jae YM. Suicide and psychiatric disorder. J Korean Soc Biol Ther Psychiatry. 2004. 10(1):3–10.

12. Jang MH, Kim YH. The relationship of stress, depression and suicidal ideation in the elderly. J Korean Acad Psychiatr Ment Health Nurs. 2005. 14(1):33–42.

13. Ji HR, Choi SH, Cho MS. The effects of a dementia nursing intervention program on cognitive function, depression, and social behavior in elderly with mild dementia. J Korean Gerontol Nurs. 2003. 5(2):205–217.

14. Jung YM, Kim JH. Comparison of cognitive levels, nutritional status, depression in the elderly according to living situations. J Korean Acad Nurs. 2004. 34(3):495–503.

15. Kee BS. A preliminary study for the standardization of geriatric depression scale short form-Korea version. J Korean Neuropsychiatr Assoc. 1996. 35(2):298–307.

16. Kim CY. The cognitive function and activities of daily living of the aged with dementia in the medical and welfare facilities for aged. 2006. Seoul: Chung-Ang University;Unpublished master's thesis.

17. Kim HS. A study on epistemology of Korean elder's suicidal thought. J Korea Gerontol Soc. 2002. 22(1):159–172.

18. Lee DY, Lee KU, Lee JH, Kim KW, Jhoo JH, Youn JC, et al. A normative study of the mini-mental state examination in the Korean elderly. J Korean Neuropsychiatr Assoc. 2002. 41(3):508–525.

19. Lee GJ, Lee KL, Yang S, Jun WH. Quality of life and the associated factors in dementia. J Korean Acad Psychiatr Ment Health Nurs. 2008. 17(3):273–280.

20. Mahoney FI, Barthel DW. Functional evaluation: The barthel index. Md State Med J. 1965. 14:61–65.

21. Oh YH. The elderly dementia survey and countermeasure. 2008. Seoul: Korea Institute for Health and Social Affairs.

22. Park JH, Lee SB, Lee TJ, Lee DY, Jhoo JH, Youn JC, et al. Depression in vascular dementia is quantitatively and qualitatively different from depression in Alzheimer's disease. Dement Geriatr Cogn Disord. 2007. 23(2):67–73. http://dx.doi.org/10.1159/000097039.

23. Rubio A, Vestner AL, Stewart JM, Forbes NT, Conwell Y, Cox C. Suicide and Alzheimer's pathology in the elderly: A case-control study. Biol Psychiatry. 2001. 49(2):137–145.

24. Ryu KH, Kang YW, Na DL, Lee KH, Chung CS. The characteristics of depression in dementia patients. Korean J Clin Psychol. 2000. 19(1):117–129.

25. Seignourel PJ, Kunik ME, Snow L, Wilson N, Stanley M. Anxiety in dementia: A critical review. Clin Psychol Rev. 2008. 28(7):1071–1082. http://dx.doi.org/10.1016/j.cpr.2008.02.008.

26. Seoul National University Bundang Hospital. Survey on dementia care of Korea. Ministry of Health and Welfare. 2011. Retrieved November 20, 2012. from http://library.mw.go.kr/Users/bogun/K/Go/PdfViewer.aspx?mastid=72241&pdf_url=MS036156.pdfhttp://library.mw.go.kr/Users/bogun/K/Go/PdfViewer.aspx?mastid=72241&pdf_url=MS036156.pdf.

27. Sheikh JI, Yesavage JA. Geriatric depression scale (GDS): Recent evidence and development of a shorter violence. Clin Gerontol. 1986. 5(1-2):165–173. http://dx.doi.org/10.1300/J018v05n01_09.

28. Song SR. Association of depression, cognitive function and daily living activity of the poor elderly. 2010. Gwangju: Chonnam National University;Unpublished master's thesis.

29. Starkstein SE, Jorge R, Mizrahi R, Robinson RG. The construct of minor and major depression in Alzheimer's disease. Am J Psychiatry. 2005. 162(11):2086–2093. http://dx.doi.org/10.1176/appi.ajp.162.11.2086.

30. Tsai CF, Tsai SJ, Yang CH, Hwang JP. Chinese demented inpatients admitted following a suicide attempt: A case series. Int J Geriatr Psychiatry. 2007. 22(11):1106–1109. http://dx.doi.org/10.1002/gps.1795.