Associations Between Mental-Health Factors, Quality of Life, and Suicidal Ideation in Korean Elderly.

Background/

Objectives

This study examined associations of mental health and health-related quality of life (HRQOL) with suicidal ideation among older Korean adults, and whether an HRQOL difference persisted after adjustment for depressive symptoms.

Methods

The 2022 Korea Community Health Survey included 79,441 adults aged ≥65 years. The outcome was a past-year report of thoughts of wanting to die, which may include passive death wishes. Complex-samples logistic models used categorical PHQ-8, self-rated health, and stress (n = 78,838). An exploratory design-based linear analysis estimated adjusted EQ-5D differences (n = 79,033).

Results

The weighted outcome prevalence was 9.9% (95% CI 9.6-10.2). Standardized prevalences across the PHQ-8 categories were 6.5%, 13.6%, 18.7%, and 23.9%; the highest versus lowest category difference was 17.4 percentage points (95% CI 14.3-20.5). Stress and EQ-5D anxiety/depression were positively associated with the outcome, whereas happiness was inversely associated (aOR 0.770, 95% CI 0.751-0.790). The adjusted EQ-5D mean difference for respondents with versus without the outcome was -0.0531 (95% CI -0.0589 to -0.0473). The primary mental-health associations persisted with expanded covariates; some physical-domain estimates depended on specification or variance handling.

Conclusions

Depressive symptoms, stress, anxiety/depression, and happiness were associated with the outcome, and an HRQOL difference persisted after depressive-symptom adjustment. These mutually adjusted, cross-sectional findings concern a single item that may include passive death wishes and do not establish causal effects or a clinical diagnosis.