Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, New York, NY, United States of America.
Northeastern University, Boston, MA, United States of America.
J Affect Disord. 2023 Aug 1;334:43-49. doi: 10.1016/j.jad.2023.04.038. Epub 2023 Apr 20.
We aimed to characterize the prevalence of social disconnection and thoughts of suicide among older adults in the United States, and examine the association between them in a large naturalistic study.
We analyzed data from 6 waves of a fifty-state non-probability survey among US adults conducted between February and December 2021. The internet-based survey collected the PHQ-9, as well as multiple measures of social connectedness. We applied multiple logistic regression to analyze the association between presence of thoughts of suicide and social disconnection. Exploratory analysis, using generalized random forests, examined heterogeneity of effects across sociodemographic groups.
Of 16,164 survey respondents age 65 and older, mean age was 70.9 (SD 5.0); the cohort was 61.4 % female and 29.6 % male; 2.0 % Asian, 6.7 % Black, 2.2 % Hispanic, and 86.8 % White. A total of 1144 (7.1 %) reported thoughts of suicide at least several days in the prior 2 week period. In models adjusted for sociodemographic features, households with 3 or more additional members (adjusted OR 1.73, 95 % CI 1.28-2.33) and lack of social supports, particularly emotional supports (adjusted OR 2.60, 95 % CI 2.09-3.23), were independently associated with greater likelihood of reporting such thoughts, as was greater reported loneliness (adjusted OR 1.75, 95 % CI 1.64-1.87). The effects of emotional support varied significantly across sociodemographic groups.
Thoughts of suicide are common among older adults in the US, and associated with lack of social support, but not with living alone.
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本研究旨在描述美国老年人社会隔离和自杀意念的流行情况，并在一项大型自然主义研究中探讨两者之间的关联。
我们分析了 2021 年 2 月至 12 月期间在美国进行的一项涵盖 50 个州的非概率调查的 6 个波次的数据。这项基于互联网的调查收集了 PHQ-9 以及多项社会联系衡量指标。我们应用多项逻辑回归分析了存在自杀意念与社会隔离之间的关联。通过广义随机森林进行的探索性分析，考察了社会人口统计学群体之间效应的异质性。
在 16164 名年龄在 65 岁及以上的调查受访者中，平均年龄为 70.9（标准差为 5.0）；该队列中 61.4%为女性，29.6%为男性；2.0%为亚洲人，6.7%为黑人，2.2%为西班牙裔，86.8%为白人。共有 1144 人（7.1%）报告在过去 2 周内至少有几天有自杀意念。在调整了社会人口统计学特征的模型中，有 3 个或更多额外成员的家庭（调整后的比值比 1.73，95%置信区间 1.28-2.33）和缺乏社会支持，特别是缺乏情感支持（调整后的比值比 2.60，95%置信区间 2.09-3.23），与更有可能报告此类想法独立相关，报告的孤独感更强（调整后的比值比 1.75，95%置信区间 1.64-1.87）。情感支持的效果在社会人口统计学群体中差异显著。
自杀意念在美国老年人中较为常见，与缺乏社会支持有关，但与独居无关。
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