Does disability predict attempted suicide in the elderly? A community-based study of elderly residents in Shanghai, China

Abstract

Objectives: Disability, which has been proved to be associated with suicide and suicidal ideation, has received little attention in relation to suicidal attempts among the elderly. The aim of this study was to explore the influence of disability on attempted suicide within this demographic.Method: A multi-stage cluster sample of 8399 residents aged 60 or more was investigated from 15 communities in Shanghai, China. Disability was measured using the Lawton instrumental activities of daily living (IADL) scale.Results: The prevalence of attempted suicide in the elderly was 0.75%. Specific IADL disabilities, including shopping (OR = 3.01, 95% CI = 1.56–5.81), preparing meals (OR = 4.12, 95% CI = 2.12–8.00), housekeeping (OR = 2.48, 95% CI = 1.01–6.06), doing laundry (OR = 2.82, 95% CI = 1.09–7.35), using transport (OR = 3.10, 95% CI = 1.36–6.99) and medical care (OR = 4.41, 95% CI = 2.10–9.17), were significantly and independently associated with attempted suicide in the elderly. The presence of at least one such disability was associated with an almost threefold increase in the attempted suicide rate, and the presence of five or more IADL disabilities was associated with an approximate fivefold increase in the attempted suicide rate.Conclusion: Specific IADL disabilities, such as preparing meals or dealing with medical care, may be significant predictive factors for risk of suicidal attempts among the elderly. Therefore, elderly people with certain disabilities should be considered for suicide prevention interventions and should be supported in IADL as much as possible.