The Relationship Between Elder Mistreatment and Suicidal Ideation in Rural Older Adults in China

Apr 10, 2013The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry

Elder abuse and thoughts of suicide in older adults living in rural China

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Abstract

Elder adults who experienced mistreatment had a significantly higher rate of suicidal ideation, with 17.4% in men and 15.8% in women reporting such thoughts.

The rate of suicidal ideation in older men with mistreatment was 17.4%, compared to 2.4% in those without mistreatment.
In older women, the rate of suicidal ideation was 15.8% among those who experienced mistreatment, versus 4.0% in others.
Psychological mistreatment is associated with a fivefold increased risk of suicidal ideation in older adults.
Financial mistreatment is linked to a fourfold increased risk of suicidal ideation in older adults.
Among men, both psychological and financial mistreatment are associated with increased suicidal thoughts.
Among women, physical and psychological mistreatment are associated with increased suicidal thoughts.

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OBJECTIVE: The aim of this study was to examine the association of elder mistreatment subtypes and suicidal ideation in adults age 60 years and older residing in a Chinese rural community.

METHODS: We conducted a population-based cross-sectional survey in 2010 and 2,039 adults age 60 and older, living in Macheng city of Hubei province, China, were interviewed face-to-face using a structured questionnaire. Multivariate logistic regression analyses were used to determine the independent effect of elder mistreatment to suicidal ideation among older adults.

RESULTS: Older adults who endorsed mistreatment had a significantly higher rate of suicidal ideation than those without elder mistreatment both in men (17.4% versus 2.4%; χ(2) = 58.04, p <0.01) and women (15.8% versus 4.0%; χ(2) = 50.24, p <0.01). After adjusting for potential confounding factors, psychological mistreatment (OR: 5.0; 95% CI: 2.5-9.8) and financial mistreatment (OR: 4.1; 95% CI: 1.2-14.7) were positively associated with suicidal ideation. Among men, psychological mistreatment (OR: 5.4; 95% CI: 2.6-11.2) and financial mistreatment (OR: 4.2; 95% CI: 1.1-16.2) were positively associated with suicidal ideation. Among women, physical mistreatment (OR: 4.5; 95% CI: 2.2-9.2) and psychological mistreatment (OR: 2.6; 95% CI: 1.5-4.4) were positively associated with suicidal ideation.

CONCLUSION: This is the first study that demonstrates that elder adults who experienced mistreatment are at increased risk for suicidal ideation. Our findings suggest that clinicians need to consider mistreatment exposure in older patients who have suicidal ideation. Victims of elder mistreatment should be the targets for suicide monitoring and prevention programs.

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