Functional disability, depression, and suicidal ideation in older prisoners

Area of Science:

• Geriatric Psychiatry
• Criminology
• Public Health

Background:

• The population of older prisoners (age ≥50) is increasing, presenting unique challenges due to high suicide rates.
• Functional disability and depression are prevalent among older inmates, raising concerns about their impact on mental health.

Purpose of the Study:

• To investigate the associations between functional disability, depression, and suicidal ideation (SI) in older male prisoners.
• To examine the mediating role of depression in the relationship between functional disability and SI within this demographic.

Main Methods:

• A cross-sectional study involving 220 male inmates aged 50 and above.
• Functional disability assessed using the Short Physical Performance Battery (SPPB) and self-reported difficulty with activities like climbing stairs and daily living (PADLS).
• Depression and SI measured using the PHQ-9 and Geriatric Suicide Ideation Scale, respectively; data analyzed with regression and mediation models.

Main Results:

• Functional disability measures were significantly associated with depressive symptoms.
• Self-reported difficulty climbing stairs and PADL disability, but not SPPB scores, were independently linked to SI.
• Depressive symptoms significantly mediated the association between functional disability (both objective and self-reported) and SI.

Conclusions:

• Depression plays a crucial role in the pathway from functional disability to suicidal ideation among older prisoners.
• Suicide prevention strategies for this growing population should prioritize individuals with depression, including those with functional limitations.
• Assessing functional disability may serve as an effective method for identifying older prisoners who require screening for depression and suicidal ideation.