Cross-national prevalence and factors associated with suicide ideation and attempts in older and young-and-middle age people

Abstract

Objectives: To report prevalence estimates of 12-month suicide ideation and attempts in young-and-middle age adults and older people, as well as their respective associated factors.

Methods: A total of 52,150 community-dwelling adults who completed the adapted version of the Composite International Diagnostic Interview-Depression Module were included from SAGE and COURAGE in Europe studies. The presence of 12-month suicide ideation and attempts was measured among the participants who screened positively in the Depression Module. Global and national prevalence estimates of 12-month suicide ideation and attempts were calculated according to the total sample. Logistic regression analyses were conducted to separately determine factors associated with suicidal ideation and with suicide attempts in young-and-middle age adults and older adults.

Results: Higher estimates of 12-month suicidal ideation were found for high-income countries and people aged 65 years and older. Higher negative affect, higher disability, and presence of food insecurity were associated with 12-month suicidal ideation and suicide attempts for young-and-middle-adults and older adults. Higher isolation, being female, and greater number of chronic health conditions were also related to 12-month suicidal ideation in both age groups. Younger age was associated with 12-month suicidal ideation for older people, and with suicide attempts in the young-and-middle age group. Finally, higher income was related to lower rates of 12-month suicidal ideation for the young-and-middle age group.

Conclusions: Older people are at increased risk of suicidal ideation globally and of suicide attempts in some countries. There were common and different factors related to suicide in adults and older adults.

Keywords:

• Epidemiology
• cross-national study
• prevalence
• suicide

Acknowledgments

The authors sincerely acknowledge the immense contribution of the research participants from China, Finland, Ghana, India, Mexico, Poland, Russia, South Africa, and Spain, without whom this study would not have been possible. We would also like to acknowledge the principal investigators at the SAGE sites: P. Arokiasamy (India), R. Biritwum (Ghana), Wu Fan (China), R. López Ridaura (Mexico), T. Maximova (Russia) and N. Phaswanamafuya (South Africa).

Disclosure statement

No conflict of interest was reported by the authors. The views expressed in this paper are those of the authors, and do not necessarily represent the views or policies of the World Health Organization.

Data availability statement

The raw data from Study on global AGEing and adult health (SAGE) are available through the WHO Multi-Country Studies Data Archive at: http://apps.who.int/healthinfo/systems/surveydata/index.php/catalog.

The specific data from COllaborative Research on AGEing in Europe (COURAGE in Europe) supporting the findings of the present study are available from the first author [MC], upon reasonable request.

Additional information

Funding

The research leading to these results has received funding from US National Institute on Aging Interagency Agreements (OGHA 04034785, YA1323–08-CN- 0020, Y1-AG-1005-01) and research grant (R01-AG034479), European Community’s Seventh Framework Programme (grant agreement 223071 - COURAGE in Europe), by the Spanish Ministry of Science and Innovation ACI-Promociona (ACI2009-1010), and by the Instituto de Salud Carlos III-FIS research grants [PS09/00295, PS09/01845, PI12/01490, PI13/00059, PI16/00218, and PI16/01073]. Projects PI12/01490, PI13/00059, PI16/00218, and PI16/01073 have been co-funded by the European Union European Regional Development Fund (ERDF) “A Way to Build Europe”, The study was supported by the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM).