What was associated with suicide planning in middle-aged and older adults during the COVID-19 lockdown?

During the lockdown period, the challenges faced and their consequences differed by age group, making it necessary to understand the factors influencing suicidal behaviors, such as suicide planning, across different ages. This study aimed to identify the risk factors for suicide planning in middle-aged and older adults.

A cross-sectional analysis was performed by combining KNHANES 2020-2021 data for people aged 40 and older with National Mental Health Statistics 2020-2021 data on the number of mental health professionals per capita. Logistic regression analysis was conducted to identify demographic, health behavior, health status, and health access factors that affected suicide planning by dividing the participants into the middle-aged (40-64 years old) and older adult (65 years old or older) groups.

The proportion of suicide planning among middle-aged and older adults was 1.21% and 1.36%, respectively. The proportion of participants with suicide plans who had attempted suicide was 20.52% among older adults and 14.09% among middle-aged adults. In both groups, a diagnosis of depression and high stress were consistently associated with suicide planning. In the middle-aged group, current smoking (OR = 2.27, p = 0.023) and unmet healthcare needs (OR = 2.32, p = 0.024) increased the risk of suicide planning. In the older adult group, living alone (OR = 2.72, p = 0.002) increased this risk.

The prevalence of suicide attempts was higher among those with a suicide plan than among those without a suicide plan. For both middle-aged and older adult groups, it is important to provide mental health care aimed at suicide prevention, especially for those with depressive disorders or high stress levels. Additionally, providing alternative stress management resources for middle-aged smokers and monitoring isolated older adults could be effective prevention strategies.