Korean J Health Promot.  2022 Dec;22(4):201-210. 10.15384/kjhp.2022.22.4.201.

Factors Related to Suicidal Ldeation in Community-Dwelling Older Adults with Multimorbidity Using Data From the 2017 Korean Community Health Survey

• Kim SH
• Son YJ

• KMID: 2537440
• DOI: http://doi.org/10.15384/kjhp.2022.22.4.201

Abstract

Background
Multimorbidity and suicide rates are on the rising among older Korean population. Recent studies have shown that multimorbidity is associated with increased suicidal ideation. Thus, this study was to investigate individual factors of suicidal ideation among older Korean adults with multimorbidity.
Methods
A cross-sectional study was conducted using a subsample (n=20,533) with multimorbidity aged 65 over of the 2017 Korean community health survey. Binary logistic regression model assessed the association of physical activity, sitting times, self-reported sleep duration, and depression with suicidal ideation in older adults with multimorbidity.
Results
Overall, 2,790 (13.6%) of the sample reported suicidal ideation within the past year. Logistic regression analysis showed that women, low monthly family income, low physical activity, long sitting times, inappropriate sleep duration and depression were significantly associated with increased risk of suicidal ideation in older adults with multimorbidity.
Conclusions
To reduce the rate of suicidal ideation in older adults with multimorbidity, healthcare providers should be aware of the importance on routine assessment for physical activities, sleep pattern, and mental status of older adults in clinical settings. Particularly, female and low-income older adults with multimorbidity should be prioritized for early detection and individualized suicide prevention based on our findings.

Keyword

Multimorbidity; Aged; Suicidal ideation; Community

Figure

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  Fig. 1. Flowchart of subjects included in the study. HTN, hypertension; DM, diabetes mellitus.

Reference

1. Statistics Korea. Cause of death statistics [Internet]. Daejeon: Statistics Korea;2020. [cited Aug 25, 2022]. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1B34E01&conn_path=I2&language=en.

2. OECD. Health status: causes of mortality (intentional self-harm) [Internet]. Paris: OECD;2022. [cited Aug 25, 2022] Available from: https://data.oecd.org/healthstat/suicide-rates.htm.

3. Stickley A, Koyanagi A, Ueda M, Inoue Y, Waldman K, Oh H. Physical multimorbidity and suicidal behavior in the general population in the United States. J Affect Disord. 2020; 260:604–9.

4. Kavalidou K, Smith DJ, Der G, O’Connor RC. The role of physical and mental multimorbidity in suicidal thoughts and behaviours in a Scottish population cohort study. BMC Psychiatry. 2019; 19(1):38.

5. Chang Q, Chan CH, Yip PSF. A meta-analytic review on social relationships and suicidal ideation among older adults. Soc Sci Med. 2017; 191:65–76.

6. Ju YJ, Park EC, Han KT, Choi JW, Kim JL, Cho KH, et al. Low socioeconomic status and suicidal ideation among elderly individuals. Int Psychogeriatr. 2016; 28(12):2055–66.

7. Cho MS. Factors associated with suicidal ideation: comparisons between elderly living alone and living with others using 2017 national survey of older Koreans. Korean J Health Promot. 2019; 36(2):53–64.

8. Vancampfort D, Koyanagi A, Ward PB, Rosenbaum S, Schuch FB, Mugisha J, et al. Chronic physical conditions, multimorbidity and physical activity across 46 low- and middle-income countries. Int J Behav Nutr Phys Act. 2017; 14(1):6.

9. Ahmedani BK, Peterson EL, Hu Y, Rossom RC, Lynch F, Lu CY, et al. Major physical health conditions and risk of suicide. Am J Prev Med. 2017; 53(3):308–15.

10. Han YH, Yoo JH, Cho IY. Association between multimorbidity and suicidal ideation in Korean elderly. Korean J Family Pract. 2019; 9(6):546–53.

11. Huh Y, Nam GE, Kim YH, Lee JH. Relationships between multimorbidity and suicidal thoughts and plans among Korean adults. J Clin Med. 2019; 8(8):1094.

12. Na KS, Geem ZW, Cho SE. The development of a suicidal ideation predictive model for community-dwelling elderly aged >55 years. Neuropsychiatr Dis Treat. 2022; 18:163–72.

13. Kim HJ. Conjunctive predictors of suicidal ideation in Korean elderly : panel data analysis. Korea Convergence Society. 2019; 10(7):391–7.

14. Ryan A, Murphy C, Boland F, Galvin R, Smith SM. What is the impact of physical activity and physical function on the development of multimorbidity in older adults over time? A population-based cohort study. J Gerontol A Biol Sci Med Sci. 2018; 73(11):1538–44.

15. An KO, Jang JY, Kim J. Sedentary behavior and sleep duration are associated with both stress symptoms and suicidal thoughts in Korean adults. Tohoku J Exp Med. 2015; 237(4):279–86.

16. Jeon CW, Lee KH, Lee K, Sakong JK, Kwak KP. The risk factors affecting suicidal ideation in community dwelling elderly individuals and prediction of suicidal ideation through assessment tools. J Korean Soc Biol Ther Psychiatry. 2019; 25(3):232–41.

17. Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. 2018 Korean Society for the Study of Obesity guideline for the management of obesity in Korea. J Obes Metab Syndr. 2019; 28(1):40–5.

18. Oh JY, Yang YJ, Kim BS, Kang JH. Validity and reliability of Korean version of international physical activity questionnaire (IPAQ) short form. J Korean Acad Fam Med. 2007; 28(7):532–41.

19. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003; 35:1381–95.

20. Imran TF, Ommerborn M, Clark C, Correa A, Dubbert P, Gaziano JM, et al. Television viewing time, physical activity, and mortality among African Americans. Prev Chronic Dis. 2018; 15:E10.

21. Park JH, Moon JH, Kim HJ, Kong MH, Oh YH. Sedentary lifestyle: overview of updated evidence of potential health risks. Korean J Fam Med. 2020; 41(6):365–73.

22. Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National sleep foundation's updated sleep duration recommendations: final report. Sleep Health. 2015; 1(4):233–43.

23. Shin D, Hur J, Cho KH, Cho EH. Trends of self-reported sleep duration in Korean adults: results from the Korea national health and nutrition examination survey 2007-2015. Sleep Med. 2018; 52:103–6.

24. Korean Society of Sleep Medicine (KSSM). Adequate sleep time. Sleep Med Res [Internet]. Seoul: KSSM;[cited Aug 28, 2022]. Available from: https://www.sleepmed.or.kr/content/info/sleeptime.html.

25. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16(9):606–13.

26. Korea Center for Disease Control and Prevention. Community Health Survey [Internet]. Cheongju: Korea Centers for Disease Control and Prevention;2017. [cited Aug 2, 2022]. Available from: https://chs.kdca.go.kr/chs/index.do.

27. Agur K, McLean G, Hunt K, Guthrie B, Mercer SW. How does sex influence multimorbidity? Secondary analysis of a large nationally representative dataset. Int J Environ Res Public Health. 2016; 13(4):391.

28. He L, Biddle SJH, Lee JT, Duolikun N, Zhang L, Wang Z, et al. The prevalence of multimorbidity and its association with physical activity and sleep duration in middle aged and elderly adults: a longitudinal analysis from China. Int J Behav Nutr Phys Act. 2021; 18(1):77.

29. Read JR, Sharpe L, Modini M, Dear BF. Multimorbidity and depression: a systematic review and meta-analysis. J Affect Disord. 2017; 221:36–46.

30. Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, et al. Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychol Bull. 2017; 143(2):187–232.