University of Connecticut School of Medicine, Department of Psychiatry, Farmington, CT 06030-5215, US; University of Connecticut Health Center, UConn Center on Aging, Farmington, CT 06030-5215, US.
University of Connecticut Health Center, Health Disparities Institute, Farmington, CT 06030-7030, US.
J Affect Disord. 2020 Apr 1;266:366-373. doi: 10.1016/j.jad.2020.01.156. Epub 2020 Jan 30.
The population of older prisoners (age ≥50), a group with high suicide rates, is growing. We sought to explore the associations among functional disability, depression, and suicidal ideation (SI) among older prisoners, focusing on the mediating role of depression.
Study participants were 220 sentenced male inmates age ≥50 who were incarcerated in 8 prisons. Face-to-face interviews were conducted following consent. Functional disability was assessed objectively, using the Short Physical Performance Battery (SPPB), and via self-report by asking participants their level of difficulty climbing stairs and completing activities necessary for daily living in prison (PADLS) such as standing in line for medications. The PHQ-9 and the Geriatric Suicide Ideation Scale assessed depressive symptoms and SI, respectively. Data were analyzed using linear regression models and causal mediation models.
Participants were racially diverse and ranged from age 50 to 79 years. Whereas each functional disability measure was significantly associated with depressive symptoms, difficulty climbing stairs and PADL disability, but not SPPB score, were independently associated with SI. Depressive symptoms mediated the relationship between functional disability, assessed both objectively and via self-report, and SI.
Cross-sectional study design; possible under-sampling of participants with depressive symptoms and SI.
Our findings have implications for suicide prevention in older prisoners. As this population continues to grow, prevention efforts should target those with depression, including but not limited to those with functional disability. Furthermore, assessing functional disability may offer a means of identifying those who should be screened for depression and suicidal ideation.
老年囚犯（年龄≥50 岁）人数不断增加，他们是自杀率较高的群体。我们旨在探讨老年囚犯中功能障碍、抑郁和自杀意念（SI）之间的关系，重点关注抑郁的中介作用。
研究对象为 220 名年龄≥50 岁、被监禁在 8 所监狱的男性囚犯。在获得同意后，通过面对面访谈进行研究。采用短体适能表现测试（SPPB）客观评估功能障碍，通过询问参与者攀爬楼梯的困难程度和完成监狱日常生活活动（PADLS）的能力（如排队取药）进行自我报告评估。使用 PHQ-9 和老年自杀意念量表分别评估抑郁症状和 SI。使用线性回归模型和因果中介模型进行数据分析。
参与者种族多样，年龄在 50 岁至 79 岁之间。虽然每个功能障碍测量都与抑郁症状显著相关，但攀爬楼梯和 PADL 障碍困难，而不是 SPPB 评分，与 SI 独立相关。抑郁症状中介了客观和自我报告评估的功能障碍与 SI 之间的关系。
横断面研究设计；可能对有抑郁症状和 SI 的参与者进行了抽样不足。
我们的研究结果对老年囚犯的自杀预防具有启示意义。随着这一人群的不断增加，预防工作应针对那些有抑郁症状的人，包括但不限于有功能障碍的人。此外，评估功能障碍可能是识别那些应该接受抑郁和自杀意念筛查的人的一种手段。
