Chronic Disease, Disability, Psychological Distress and Suicide Ideation among Rural Elderly: Results from a Population Survey in Shandong

Abstract

Objective: Suicide is a major public health and social problem in contemporary societies. Previous studies showed that the older the seniors were, the more likely it was that they would experience disability, chronic disease, or both. The objective of this study was to examine the joint effects of chronic disease and physical disability on suicide ideation while controlling for psychological distress among the rural elderly living in Shandong Province, China. Method: A total of 5514 rural elderly individuals (60+) living in Shandong Province, China were included in this study. Suicidal ideation was assessed by using questions from the National Comorbidity Survey (NCS). Multiple logistic analyses were performed to examine the factors associated with suicide ideation. A path analysis was conducted to test the direct and indirect effects of chronic disease and of activity of daily living (ADL) limitation on suicide ideation while controlling for psychological distress. Results: The prevalence of suicide ideation among the rural elderly in Shandong, China was 11.0%. Psychological distress had the strongest direct (β = 0.392) and total effect (β = 0.392), chronic disease (β = −0.034; β = −0.063) had both direct and indirect impacts, and ADL (β = 0.091) had indirect impacts on suicide ideation. Psychological distress was a mediator between chronic disease, ADL limitation, and suicide ideation. Conclusions: Psychological distress was the greatest influencing factor of suicide ideation among the rural elderly, followed by chronic disease and disability. Effective intervention measures should be taken to facilitate the early detection of psychological distress in clinical practice among the rural elderly.

The relationship between activities of daily living and suicidal ideation among Chinese rural older adults: a multiple mediation model through sleep quality and psychological distress

“…The current study found that the prevalence of SI among rural older adults in Shandong Province was 10.6%. This was similar to another survey conducted in rural Shandong (11.0%) [ 12 ]. It was also close to the reported rates in the older US Chinese population (9.4%) [ 21 ].…”

“…The higher the level of psychological distress, the more likely to the older adults suffer from SI. A study has shown that ADL disability promoted SI by increasing psychological distress among Chinese rural older adults [ 12 ]. Our study revealed that psychological distress played the largest mediating role in the association between ADL and SI.…”

“…Another study found that psychological distress was significantly correlated with ADL among Chinese older adults [ 11 ]. Recently, Zhu et al found that psychological distress played a mediating role between ADL and SI [ 12 ]. Based on the above analysis, psychological distress might be a mediator for ADL and SI.…”

A Cross-Sectional Study of the Prevalence of and Risk Factors for Suicidal Ideation Among the Elderly in Nursing Homes in Hunan Province, China

“…The present study also found that a history of chronic disease was associated with suicidal thoughts, which was consistent with other studies carried out in China and in other countries (42,43). A study conducted among 5,514 rural elderly individuals in Shandong province, China, found that chronic disease had both direct and indirect impacts on suicidal ideation (44). Moreover, Handley et al (45) found that within high psychological distress, lower physical functioning significantly increased the likelihood of suicidal ideation, with high distress and low functioning being associated with ideation in 50% of cases through a decision tree analysis.…”

Impact of the comprehensive outpatient rehabilitation on reducing intensification of depressive symptoms in people over 60 years of age

“…The legitimacy of conducting comprehensive rehabilitation and activating activities of seniors has been confirmed in many empirical works [3,9,16]. Research conducted by the Zhu team on a population of 5514 people over 60 prove that the leading factors determining the occurrence of affective disorders, especially suicidal thoughts in the seniors' population are limitations in everyday activity and functional ability resulting from experienced chronic diseases [17]. However other studies demonstrate that as a result of a rehabilitation program in elderly people with mild depression, a significant improvement in mental health was achieved -there was a reduction in the severity of depressive symptoms and perceived stress, as well as improved physical fitness [6].…”