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衰弱与老年人自杀意念的关联:一项横断面研究。

Association between frailty and suicidal ideation in older adults: A cross-sectional study.

机构信息

School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, PR China.

Department of Nursing, Nantong University Affiliated Rugao Hospital, The People's Hospital of Rugao, Nantong, Jiangsu, PR China.

出版信息

J Psychiatr Res. 2024 Dec;180:251-257. doi: 10.1016/j.jpsychires.2024.10.024. Epub 2024 Oct 22.

DOI:10.1016/j.jpsychires.2024.10.024
PMID:39454492
Abstract

OBJECTIVES

This study seeks to investigate the potential correlation between various levels of frailty and suicidal ideation (SI) in older adults from the USA.

METHODS

Our cross-sectional study extracted data on adults ≥60 years from the NHANES in 2005-2018. Frailty levels were assessed by computing the Frailty Index, classifying individuals into robust, prefrail, and frail categories. SI was evaluated utilizing Item #9 of PHQ-9. Logistic regression and restricted cubic splines were employed for analysis.

RESULTS

The analysis comprised 8564 participants, revealing that 3.3% reported experiencing SI. The association between frailty and SI in older adults was statistically significant in crude model (OR: 5.94, 95% CI: 3.46-11.27, P < 0.001). Upon adjusting for baseline characteristics, the association remained robust (AOR: 5.35, 95% CI: 3.09-10.19, P < 0.001). Model II did not substantially alter the association between frailty and SI after further adjustment for lifestyle factors (AOR: 5.23, 95% CI: 3.02-9.98, P < 0.001). In a sensitivity analysis controlling for depression, the association remained statistically significant (AOR:3.62, 95%CI: 1.76-8.75, P = 0.001). Furthermore, the associations between the Frailty Index and SI were pronounced in the restricted cubic spline (RCS) models (P < 0.001, P  = 0.771).

CONCLUSION

Frailty appears to heighten vulnerability to suicidal ideation in older adults. Training healthcare professionals to identify and address mental health issues related to frailty is crucial. Through comprehensive intervention measures, we can better safeguard the mental well-being of older adults and reduce the risk of suicide.

摘要

目的

本研究旨在探讨美国老年人不同衰弱程度与自杀意念(SI)之间的潜在相关性。

方法

我们的横断面研究从 2005 年至 2018 年的 NHANES 中提取了≥60 岁成年人的数据。通过计算衰弱指数来评估衰弱程度,将个体分为强壮、衰弱前期和衰弱三个类别。使用 PHQ-9 的项目#9 评估 SI。采用逻辑回归和限制立方样条进行分析。

结果

分析包括 8564 名参与者,其中 3.3%报告有 SI。在未调整的模型中,衰弱与老年人 SI 之间存在统计学显著关联(OR:5.94,95%CI:3.46-11.27,P<0.001)。在校正基线特征后,关联仍然稳健(AOR:5.35,95%CI:3.09-10.19,P<0.001)。在进一步调整生活方式因素后,模型 II 并未显著改变衰弱与 SI 之间的关联(AOR:5.23,95%CI:3.02-9.98,P<0.001)。在控制抑郁的敏感性分析中,关联仍然具有统计学意义(AOR:3.62,95%CI:1.76-8.75,P=0.001)。此外,衰弱指数与 SI 之间的关联在限制立方样条(RCS)模型中较为明显(P<0.001,P=0.771)。

结论

衰弱似乎会增加老年人自杀意念的易感性。培训医疗保健专业人员识别和处理与衰弱相关的心理健康问题至关重要。通过综合干预措施,我们可以更好地维护老年人的心理健康,降低自杀风险。

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