The objective of the present study was to evaluate the association between suicidal ideation and potentially related factors in an elderly urban Japanese population. This was a community-based, cross-sectional study. Urban community residents aged 70 years or more were interviewed regarding suicidal ideation and sociodemographic and health-related variables. Subjects with depressive symptoms underwent further evaluation by psychiatrists using criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Associations were evaluated using univariate and multivariate logistic regression analyses. Of the 1145 eligible participants, 52 (4.5%) reported thoughts of suicide. Of 143 subjects with depressive symptoms (Geriatric Depression Scale, 14 + ), 22 (15.4%) reported suicidal ideation over a 2-week period. After controlling for depressive symptoms, lack of social support and impaired instrumental activities of daily living were significantly associated with thoughts of suicide. After controlling for the potentially associated factors detected in the univariate analysis, depressive symptoms were strongly associated with thoughts of suicide. In the elderly with depressive symptoms, mental disorders, including depressive and alcoholrelated disorders, were significantly associated with suicidal ideation over a 2-week period. In the urban community setting, screening for lack of social support, impaired instrumental activities of daily living, and depressive symptoms, followed by diagnostic evaluation for mental disorders, particularly for depressive syndromes and alcohol-related disorders, may provide a practical and effective means of identifying elders at high risk of suicide.

We conducted a prospective cohort study on subjects aged ≥ 70 years in an urban community to determine whether there is any association between lack of social support and depression status. Of the 2730 eligible subjects, 1178 participated and were interviewed in a Comprehensive Geriatric Assessment (CGA) in 2002. We investigated the five social supports items using the following questions: (i) do you have someone with whom you can consult when you are in trouble?, (ii) do you have someone with whom you can consult when your physical condition is not good?, (iii) do you have someone who can help you with your daily housework?, (iv) do you have someone who can take you to a hospital when you do not feel well?, and (v) do you have someone who can take care of you when you are ill in bed? The Geriatric Depression Scale was used to estimate depression status. The subjects were divided into two groups: depressive and non-depressive. Of 753 subjects classified as non-depressive, 475 also took part in a CGA in 2003 and 278 dropped out. We calculated the risk of depression status in the elderly without social support. Lack of social support items (i) and (v) were significantly associated with an increased risk of depression status. The multivariate odds ratios (95% confidence intervals) regarding the risk of depression status among the elderly without (i) and (v) social support items were 2.6 (1.2-5.3) and 3.0 (1.4-6.1), respectively. We also found the increase risk of depression status with lack of social support item (v) was significantly different for different sexes and for different pain conditions. We conclude that there is a significant increase in the risk of depression status associated with the lack of social support in Japanese elderly people in an urban community.

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To determine the association between social support and depression in elderly Japanese, we conducted a Comprehensive Geriatric Assessment among residents aged 70 years or over. Out of 2,730 eligible subjects, 1,179 participated in the survey and 1,146 (480 men and 666 women) were analyzed. The Geriatric Depression Scale (GDS) was used to estimate depression status. The subjects were divided into two groups: depressive (GDS>11 or taking antidepressant drugs) and non-depressive (GDS<11). Various levels of social support were assessed by the following questions: Do you have someone (1) whom you can consult when you are in trouble ? (2) whom you can consult when your physical condition is not good ? (3) who can help you in daily housework ? (4) who can take you to a hospital when you don't feel well ? (5) who can take care of you when you are ill in bed? In multivariate logistic regression analysis, the calculated odds ratios (95% CIs) for the lack of each type of social support for depression status were: (1) 2.5 (1.5-4.1),(2) 1.9 (1.1-3.2),(3) 2.7 (1.7-4.4),(4) 1.9 (1.1-3.2),(5) 2.8 (1.6-4.9) in men, and (1) 1.2 (0.8-1.8),(2) 1.2 (0.8-1.8),(3) 1.4 (1.0-2.0),(4) 1.6 (1.1-2.3),(5) 2.0 (1.4-2.9) in women. A significant association was found between social support and depression in this elderly population. We also found that this association was stronger in men.