Mellqvist Fässberg Madeleine, Östling Svante, Braam Arjan W, Bäckman Kristoffer, Copeland John R M, Fichter Manfred, Kivelä Sirkka-Liisa, Lawlor Brian A, Lobo Antonio, Magnússon Halggrimur, Prince Martin J, Reischies Friedel M, Turrina Cesare, Wilson Kenneth, Skoog Ingmar, Waern Margda
Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,
Soc Psychiatry Psychiatr Epidemiol. 2014 Sep;49(9):1475-82. doi: 10.1007/s00127-014-0840-1. Epub 2014 Feb 20.
Physical illness has been shown to be a risk factor for suicidal behaviour in older adults. The association between functional disability and suicidal behaviour in older adults is less clear. The aim of this study was to examine the relationship between functional disability and death wishes in late life.
Data from 11 population studies on depression in persons aged 65 and above were pooled, yielding a total of 15,890 respondents. Level of functional disability was trichotomised (no, intermediate, high). A person was considered to have death wishes if the death wish/suicidal ideation item of the EURO-D scale was endorsed. Odds ratios for death wishes associated with functional disability were calculated in a multilevel logistic regression model.
In total, 5 % of the men and 7 % of the women reported death wishes. Both intermediate (OR 1.89, 95 % CI 1.42; 2.52) and high functional disability (OR 3.22, 95 % CI 2.34; 4.42) were associated with death wishes. No sex differences could be shown. Results remained after adding depressive symptoms to the model.
Functional disability was independently associated with death wishes in older adults. Results can help inform clinicians who care for older persons with functional impairment.
身体疾病已被证明是老年人自杀行为的一个风险因素。老年人功能残疾与自杀行为之间的关联尚不清楚。本研究的目的是探讨晚年功能残疾与死亡意愿之间的关系。
汇总了11项关于65岁及以上人群抑郁症的人口研究数据,共有15890名受访者。将功能残疾水平分为三类(无、中度、重度)。如果欧洲抑郁症量表(EURO-D)中的死亡意愿/自杀意念项目被认可,则认为该人有死亡意愿。在多水平逻辑回归模型中计算与功能残疾相关的死亡意愿的比值比。
总体而言,5%的男性和7%的女性报告有死亡意愿。中度(比值比1.89,95%置信区间1.42;2.52)和重度功能残疾(比值比3.22,95%置信区间2.34;4.42)均与死亡意愿相关。未显示出性别差异。在模型中加入抑郁症状后结果依然成立。
功能残疾与老年人的死亡意愿独立相关。研究结果可为照顾有功能障碍老年人的临床医生提供参考。