Effects of Depressive Symptom and Health Status on Several Factors that Affect Suicidal Ideation among the Elderly Living Alone in Rural Area: The Fully Mediating Effect of Depressive Symptom

ABSTRACT

BACKGROUND: The study was performed to investigate effects of depression and health status on several factors of influencing suicidal ideation among living-alone elderly in rural area. And we assessed if depressive symptom mediates fully suicidal ideation among living-alone elderly in the rural area. METHODS: The subjects of this study used the survey data of elderly people living alone for the elderly mental health promotion project at the city health center. In the questionnaire, 200 people were interviewed by one of the public health center staffs directly. We analyzed a four step approach in which several logistic regression analyses were conducted and significance of the coefficients was examined at each step. RESULTS: The results from step 1 show that the total effect of health status(frailty) was significantly related to suicidal ideation(Exp(β)=2.198, P=0.042). In step 2, the direct effect of health status on depression was significant(Exp(β)=3.925, P<0.001) too. Step 3 analysis showed that the effect of depression on suicidal ideation was significant(Exp(β)=7.115, P=0.001). Step 4 showed that after controlling for depression, health status was not significant for suicidal ideation(P=0.322). Based on analysis results, the finding supports that suicidal ideation among living-alone elderly in the rural area was fully mediated by depressive symptom. CONCLUSIONS: Above findings imply that it is crucial to decrease depression in order to control suicidal ideation among living-alone elderly in rural area. To do that, early diagnosis and developing programs to decrease elderly depression and organizational approach according to characteristics of areas and elderly circunstances are needed.