Physical multimorbidity, suicidal ideation, and suicide attempts among adults aged ≥50 years from low‐ and middle‐income countries

Lee Smith, Jae Il Shin, Guillermo F. López Sánchez, Karel Kostev, Louis Jacob, Mark A. Tully, Laurie Butler, Yvonne Barnett, Nicola Veronese, Pinar Soysal, Adel S. Abduljabbar, Josep Maria Haro, Ai Koyanagi

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Abstract

The association between physical multimorbidity and suicidal ideation or suicide attempts among older adults from low- and middle-income countries (LMICs) is largely unknown. We aimed to assess this association as well as its mediators using nationally representative data from six LMICs. Cross-sectional, community-based data from the Study on Global Aging and Adult Health were analyzed. A total of 11 chronic physical conditions were assessed. Self-reported information on past 12-month suicidal ideation and suicide attempts was also collected. Multivariable logistic regression and mediation analyses were conducted. The final sample consisted of 34,129 adults aged ≥50 years (mean [SD] age 62.4 (16.0) years; maximum age 114 years; 52.1% females). In the overall sample, physical multimorbidity was associated with increased odds for suicidal ideation (OR = 2.99; 95% CI = 2.06-4.34) and suicide attempts (OR = 2.79; 95% CI = 1.58-4.95), with the association being stronger in males than females. The association between multimorbidity and suicidal ideation or suicide attempts was largely mediated by pain/discomfort (mediated% 33.3%-44.2%), sleep/energy (28.2%-33.8%), and mobility limitations (26.6%-34.8%). Physical multimorbidity among older adults in LMICs was associated with a substantially increased risk for suicidal ideation and suicide attempts. Addressing the identified mediators in people with physical multimorbidity may aid in the prevention of suicidal ideation and suicide attempts. [Abstract copyright: © 2023 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.]
Original languageEnglish
Article numbere5873
Pages (from-to)1-12
Number of pages12
JournalInternational Journal of Geriatric Psychiatry
Volume38
Issue number1
Early online date13 Jan 2023
DOIs
Publication statusPublished (in print/issue) - 22 Jan 2023

Bibliographical note

Funding Information:
This paper uses data from WHO's Study on Global Aging and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08‐CN‐0020, Y1‐AG‐1005–01 and through research grants R01‐AG034479 and R21‐AG034263. Dr. Guillermo F. López Sánchez is funded by the European Union—Next Generation EU.

Publisher Copyright:
© 2023 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.

Keywords

  • adults
  • epidemiology
  • low‐ and middle‐income countries
  • multimorbidity
  • suicidal ideation
  • suicide attempts
  • Cross-Sectional Studies
  • Humans
  • Risk Factors
  • Male
  • Suicidal Ideation
  • Multimorbidity
  • Suicide, Attempted
  • Female
  • Aged
  • Developing Countries
  • low- and middle-income countries

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