Poverty and suicide risk in older adults: A retrospective longitudinal cohort study

Abstract

Objectives The present study evaluated suicide risk within 1 year after discharge among older adults with stroke as a function of depression onset. Method We used the Korean National Health Insurance Service‐Senior cohort data and included first discharged patients with a stroke as the principal diagnosis. The comparison group was selected by a 1:2 case‐control propensity score matching for age, sex, Charlson comorbidity index, and diagnosis year between 2005 and 2012. Suicide deaths were measured by code for causes of death from Statistics Korea, and the main outcome was suicide death within 1 year following discharge. An adjusted hazard ratio (AHR) of suicidal risk was measured using a Cox proportional hazard model. Results In the total sample of 128 286 older adults (aged 63‐114 years), the higher suicidal risk was examined for stroke patients vs the comparison group (AHR = 1.4; 95% confidence interval [CI], 1.1‐1.8). Stroke patients with depression had an increased suicide risk (AHR = 2.9; 95% CI, 1.8‐4.8) but only for poststroke depression (AHR = 4.1; 95% CI, 1.8‐9.5). Pre and poststroke depression suicidality (AHR = 4.8; 95% CI, 2.1‐11.1) was also higher when compared to stroke patients without depression. Conclusions Poststroke patients are at increased suicidal risk during 1 year following discharge. Furthermore, patients who were diagnosed with depression after a stroke are more likely to commit suicide than stroke patients without depression. This suggests a necessity for early suicide preventive intervention for stroke patients while considering depressive symptomology.

Suicide risk within 1 year of dementia diagnosis in older adults: a nationwide retrospective cohort study

“…People were divided into categories of young-old (age 60-74 years) and oldold (age > 75 years) based on a previous study. 41,42 The year of the first diagnosis of dementia in the study period was defined as the index year, and the members of the comparison group were matched with patients with dementia in the same index year. The comorbidities were diabetes mellitus (ICD-10 codes E10-E14), hypertension (ICD-10 codes I10-I15), dyslipidemia (ICD-10 code E78), Parkinson disease (ICD-10 code G20), stroke (ICD-10 codes I60-I63), ischemic heart disease (ICD-10 codes I20-25), chronic kidney disease (ICD-10 code N18) and cancer (ICD-10 codes C00-C99) and were estimated by screening information from medical records before the index date.…”

Role of SES on the association between childhood parental death and adulthood suicidal ideation: a mediation analysis using longitudinal dataset in South Korea

“…It has been found that lower SES could lead to a higher risk of mental health problems. For example, a cohort study analyzing the National Health Insurance Service-Senior claims data in Korea found that the poverty group had a higher risk of suicide than the high-income group among Korean adults aged 60 to 74 years old [ 20 ]. On the other hands, we should be cautious about interpreting the statistically non-significant results in the mediation analysis about education attainment.…”

Risk Factors and Effects of the Morbus: COVID-19 through the Biopsychosocial Model and Ecological Systems Approach to Social Work Practice

“…Like preceding health outbreaks such as the 2002 severe acute respiratory syndrome, the present COVID-19 appears to be leading to higher suicidality (Griffith & Mamum, 2020). Aside of COVID-19, approximately 75% of suicides occur in low and middle-income countries (LMICs) where rates of poverty are high [macrocosms], and evidence proposes a relationship between economic variables and suicidal behavior [microcosms] (Bantjes et al, 2016:1;Choi, Kim, Shin, & Han, 2019). In this COVID-19 pandemic, most of the suicides occur due to lockdown-related economic recession (Bhuiyan, Sakib, Pakpour, Griffiths, & Mamum, 2020;Mamun & Ullah, 2020).…”