Exploring the risk factors of suicidal ideation among the seniors in Shandong, China: A path analysis

Background: Suicide is a global public health problem that has a significant negative influence on individuals, families and the society. The objective of this study is to explore the risk factors associated with suicidal ideation among the elderly in Shandong Province, China. Method: A total of 3313 participants (60+) of Shandong Province, China were included in this study. Suicidal ideation was assessed by using questions from the NCS (National Comorbidity Survey). Multiple logistic regression analysis was performed to examine the factors associated with suicidal ideation. Path analysis was conducted to test the direct and indirect association between factors and suicidal ideation. Results: The prevalence of suicidal ideation among the seniors in Shandong, China was 4.2%. Depression had the strongest direct (beta=0.303, p-value < 0.05) and total effect (beta=0.303), life satisfaction (beta=-0.103, p-value < 0.05; beta=-0.136, p-value < 0.05), economic status (beta=-0.046, p-value < 0.05; (beta=-0.040, p-value < 0.05) had both direct and indirect impacts on suicidal ideation. Social support (beta=-0.040, p-value < 0.05) had indirect influence on suicidal ideation. Depression was a mediator between life satisfaction, economic status, social support and suicidal ideation. Limitations: The data used in this study was cross-sectional, and the relationship between identified factors and suicidal ideation cannot be interpreted as cause-effect. Conclusions: Depression was the strongest influencing factor of suicidal ideation among the elderly, followed by life satisfaction, economic status. Active intervention measures focusing on the depression screening and treatment both in urban and rural communities should be taken to prevent suicide.