Associations Between Mental-Health Factors, Quality of Life, and Suicidal Ideation in Korean Elderly

Background/Objectives: This study examined associations of mental health and health-related quality of life (HRQOL) with suicidal ideation among older Korean adults, and whether an HRQOL difference persisted after adjustment for depressive symptoms. Methods: The 2022 Korea Community Health Survey included 79,441 adults aged ≥65 years. The outcome was a past-year report of thoughts of wanting to die, which may include passive death wishes. Complex-samples logistic models used categorical PHQ-8, self-rated health, and stress (n = 78,838). An exploratory design-based linear analysis estimated adjusted EQ-5D differences (n = 79,033). Results: The weighted outcome prevalence was 9.9% (95% CI 9.6-10.2). Standardized prevalences across the PHQ-8 categories were 6.5%, 13.6%, 18.7%, and 23.9%; the highest versus lowest category difference was 17.4 percentage points (95% CI 14.3-20.5). Stress and EQ-5D anxiety/depression were positively associated with the outcome, whereas happiness was inversely associated (aOR 0.770, 95% CI 0.751-0.790). The adjusted EQ-5D mean difference for respondents with versus without the outcome was -0.0531 (95% CI -0.0589 to -0.0473). The primary mental-health associations persisted with expanded covariates; some physical-domain estimates depended on specification or variance handling. Conclusions: Depressive symptoms, stress, anxiety/depression, and happiness were associated with the outcome, and an HRQOL difference persisted after depressive-symptom adjustment. These mutually adjusted, cross-sectional findings concern a single item that may include passive death wishes and do not establish causal effects or a clinical diagnosis.