Cognitive frailty and suicidal ideation among Chinese rural empty-nest older adults: Parent-child geographic proximity as a possible moderator?

Jan 9, 2021Journal of affective disorders

Cognitive Frailty and Suicidal Thoughts in Older Adults Living Alone in Rural China: Does Living Closer to Their Children Make a Difference?

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Abstract

The prevalence of suicidal ideation among Chinese rural empty-nest older adults is 10.1%.

Cognitive frailty affects 6.2% of the same population.
Older adults with cognitive frailty are more likely to experience suicidal ideation, with an odds ratio of 1.16.
Greater geographic distance from adult children may worsen the link between cognitive frailty and suicidal ideation, indicated by an odds ratio of 4.30.
The relationship between cognitive frailty and suicidal ideation may be moderated by the living proximity of adult children.

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BACKGROUND: Few studies explored the relationship between cognitive frailty and suicidal ideation (SI), and whether geographic variable modified this relationship. This study aimed to explore the association between cognitive frailty and SI, and investigated whether parent-child geographic proximity is a moderator in this relationship among Chinese rural empty-nest older adults.

METHODS: A total of 2,549 rural empty-nest older adults (60+) were included in the analysis. SI was assessed using questions from the National Comorbidity Survey. Fried frailty phenotype and Mini Mental State Examination were used to measure cognitive frailty. Moderating effect analysis was performed using logistic regression models and margins plot.

RESULTS: The prevalence of SI and cognitive frailty were 10.1% and 6.2% among Chinese rural empty-nest older adults. Participants with cognitive frailty were more likely to suffer from SI (OR=1.16, 95% CI=1.03-2.86). We found that far geographic distance may aggravate this relationship (OR=4.30, 95% CI=1.02-10.24), especially for rural empty-nest older adults whose nearest adult child lived outside the same prefectural city with them.

LIMITATIONS: The results cannot be interpreted as causality of the data due to cross-sectional design.

CONCLUSIONS: Our findings suggested that cognitive frailty was associated with SI and parent-child geographic proximity moderated this relationship. Improving the cognitive frailty of older adults is helpful to prevent SI. Adult children living far away from rural empty-nest older adults should increase intergenerational contact and pay attention to their parents' physical and mental health.

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Cognitive frailty and suicidal ideation among Chinese rural empty-nest older adults: Parent-child geographic proximity as a possible moderator?

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