J Korean Med Sci.  2016 Apr;31(4):604-610. 10.3346/jkms.2016.31.4.604.

Body Composition, Sarcopenia, and Suicidal Ideation in Elderly Koreans: Hallym Aging Study

• Kim JH
• Kim DH
• Park YS

• KMID: 2363701
• DOI: http://doi.org/10.3346/jkms.2016.31.4.604

Abstract

This study was conducted to assess the relationship between body composition and suicidal ideation among the Korean elderly population (n = 302; ≥ 65 years) who participated in the Hallym Aging Study in 2010. Body composition was measured using dual-energy X-ray absorptiometry, and obesity was measured by the indices of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body fat percentage. Sarcopenia was defined as presence of both low muscle mass and low muscle function. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. We found no differences in body composition measures between subjects with suicidal ideation and those without. In the logistic regression analyses, there were no significant relationships for suicidal ideation according to body composition measures, including BMI, WC, WHR, WHtR, and body fat percentage in both sexes. After adjusting for age, smoking status, alcohol drinking, regular exercise, medical comorbidities, monthly income, education level, and presence of depressive symptoms, the odds ratio (OR) of suicidal ideation was higher in elderly men with sarcopenia compared to those without, whereas no significant relationships were observed in elderly women (OR 8.28, 95% confidence interval [CI] 1.20-61.34 in men; OR 0.79, 95% CI 0.07-8.43 in women). Sarcopenia is closely associated with an increased risk of suicidal ideation in elderly men.

Keyword

Suicide; Suicidal Ideation; Sarcopenia; Obesity; Elderly; Korean

MeSH Terms

Aged
*Aging
Asian Continental Ancestry Group
*Body Composition
Body Height
Body Mass Index
Depression/epidemiology
Female
Humans
Logistic Models
Male
Obesity/epidemiology
Odds Ratio
Republic of Korea
Sarcopenia/*diagnosis/psychology
*Suicidal Ideation
Waist Circumference
Waist-Hip Ratio

Reference

1. Bae SM, Lee YJ, Cho IH, Kim SJ, Im JS, Cho SJ. Risk factors for suicidal ideation of the general population. J Korean Med Sci. 2013; 28:602–607.

2. Statistics Korea. Annual Report on the Cause of Death Statistics 2011. Daejeon: Statistics Korea;2012.

3. Grimby G, Saltin B. The ageing muscle. Clin Physiol. 1983; 3:209–218.

4. Scott KM, McGee MA, Wells JE, Oakley Browne MA. Obesity and mental disorders in the adult general population. J Psychosom Res. 2008; 64:97–105.

5. Carpenter KM, Hasin DS, Allison DB, Faith MS. Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study. Am J Public Health. 2000; 90:251–257.

6. Elovainio M, Shipley MJ, Ferrie JE, Gimeno D, Vahtera J, Marmot MG, Kivimäki M. Obesity, unexplained weight loss and suicide: the original Whitehall study. J Affect Disord. 2009; 116:218–221.

7. Kaplan MS, McFarland BH, Huguet N. The relationship of body weight to suicide risk among men and women: results from the US National Health Interview Survey Linked Mortality File. J Nerv Ment Dis. 2007; 195:948–951.

8. Schneider B, Lukaschek K, Baumert J, Meisinger C, Erazo N, Ladwig KH. Living alone, obesity, and smoking increase risk for suicide independently of depressive mood findings from the population-based MONICA/KORA Augsburg cohort study. J Affect Disord. 2014; 152-154:416–421.

9. Batty GD, Whitley E, Kivimäki M, Tynelius P, Rasmussen F. Body mass index and attempted suicide: Cohort study of 1,133,019 Swedish men. Am J Epidemiol. 2010; 172:890–899.

10. Roubenoff R. Sarcopenic obesity: does muscle loss cause fat gain? Lessons from rheumatoid arthritis and osteoarthritis. Ann N Y Acad Sci. 2000; 904:553–557.

11. Lee S, Park HS, Kim SM, Kwon HS, Kim DY, Kim DJ, Cho GJ, Han JH, Kim SR, Park CY. Cut-off points of waist circumference for defining abdominal obesity in the Korean population. Korean J Obes. 2006; 15:1–9.

12. Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, Chou MY, Chen LY, Hsu PS, Krairit O, et al. Sarcopenia in Asia: consensus report of the asian working group for sarcopenia. J Am Med Dir Assoc. 2014; 15:95–101.

13. Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the scale for suicide ideation. J Consult Clin Psychol. 1979; 47:343–352.

14. Shin MS, Park KB, Oh KJ, Kim ZS. A study of suicidal ideation among high school students: the structural relation among depression, hopelessness, and suicidal ideation. Korean J Clin Psychol. 1990; 9:1–19.

15. Jung IK, Kwak DI, Joe SH, Lee HS. A study of standardization of Korean Form of Geriatric Depression Scale (KGDS). J Korean Geriatr Psychiatry. 1997; 1:61–72.

16. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-1983; 17:37–49.

17. Kim NH, Kim HS, Eun CR, Seo JA, Cho HJ, Kim SG, Choi KM, Baik SH, Choi DS, Park MH, et al. Depression is associated with sarcopenia, not central obesity, in elderly Korean men. J Am Geriatr Soc. 2011; 59:2062–2068.

18. Wagner B, Klinitzke G, Brähler E, Kersting A. Extreme obesity is associated with suicidal behavior and suicide attempts in adults: results of a population-based representative sample. Depress Anxiety. 2013; 30:975–981.

19. Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, Zitman FG. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010; 67:220–229.

20. Kim JY, Chang HM, Cho JJ, Yoo SH, Kim SY. Relationship between obesity and depression in the Korean working population. J Korean Med Sci. 2010; 25:1560–1567.

21. Dey DK, Bosaeus I, Lissner L, Steen B. Changes in body composition and its relation to muscle strength in 75-year-old men and women: a 5-year prospective follow-up study of the NORA cohort in Göteborg, Sweden. Nutrition. 2009; 25:613–619.

22. Kim S, Won CW, Kim BS, Choi HR, Moon MY. The association between the low muscle mass and osteoporosis in elderly Korean people. J Korean Med Sci. 2014; 29:995–1000.

23. Stephen WC, Janssen I. Sarcopenic-obesity and cardiovascular disease risk in the elderly. J Nutr Health Aging. 2009; 13:460–466.

24. Newman AB, Kupelian V, Visser M, Simonsick EM, Goodpaster BH, Kritchevsky SB, Tylavsky FA, Rubin SM, Harris TB. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006; 61:72–77.

25. Lim S, Kim JH, Yoon JW, Kang SM, Choi SH, Park YJ, Kim KW, Lim JY, Park KS, Jang HC. Sarcopenic obesity: prevalence and association with metabolic syndrome in the Korean Longitudinal Study on Health and Aging (KLoSHA). Diabetes Care. 2010; 33:1652–1654.

26. Kim YS, Lee Y, Chung YS, Lee DJ, Joo NS, Hong D, Ge S, Kim HJ, Choi YJ, Kim KM. Prevalence of sarcopenia and sarcopenic obesity in the Korean population based on the Fourth Korean National Health and Nutritional Examination Surveys. J Gerontol A Biol Sci Med Sci. 2012; 67:1107–1113.

27. Lee S, Kim TN, Kim SH. Sarcopenic obesity is more closely associated with knee osteoarthritis than is nonsarcopenic obesity: a cross-sectional study. Arthritis Rheum. 2012; 64:3947–3954.

28. Qin P, Hawton K, Mortensen PB, Webb R. Combined effects of physical illness and comorbid psychiatric disorder on risk of suicide in a national population study. Br J Psychiatry. 2014; 204:430–435.

29. Lucki I. The spectrum of behaviors influenced by serotonin. Biol Psychiatry. 1998; 44:151–162.

30. Mann JJ, Currier DM. Stress, genetics and epigenetic effects on the neurobiology of suicidal behavior and depression. Eur Psychiatry. 2010; 25:268–271.

31. Muldoon MF, Mackey RH, Williams KV, Korytkowski MT, Flory JD, Manuck SB. Low central nervous system serotonergic responsivity is associated with the metabolic syndrome and physical inactivity. J Clin Endocrinol Metab. 2004; 89:266–271.

32. Liu CJ, Latham NK. Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst Rev. 2009; CD002759.

33. Solerte SB, Gazzaruso C, Bonacasa R, Rondanelli M, Zamboni M, Basso C, Locatelli E, Schifino N, Giustina A, Fioravanti M. Nutritional supplements with oral amino acid mixtures increases whole-body lean mass and insulin sensitivity in elderly subjects with sarcopenia. Am J Cardiol. 2008; 101:69E–77E.