Suicidal ideation among older primary care patients

Area of Science:

• Geriatric Medicine
• Psychiatry
• Public Health

Background:

• Suicidal ideation is a critical concern among older adults, a demographic often underserved in mental health.
• Primary care settings represent a crucial point for identifying mental health issues in the elderly population.

Purpose of the Study:

• To determine the prevalence of suicidal ideation in older adults within a primary care setting.
• To identify sociodemographic and clinical factors associated with suicidal ideation in this population.
• To assess the relationship between depressive symptoms, functional status, and suicidal ideation in elderly patients.

Main Methods:

• A cross-sectional study involving 3767 patients aged 60 and older in an academic primary care practice.
• Screening included the Centers for Epidemiologic Studies Depression (CES-D) scale, functional status, and suicidal ideation.
• A subset of patients screening positive for depression (n=301) and a random sample of those screening negative (n=101) were analyzed.

Main Results:

• An estimated 0.7% to 1.2% prevalence of suicidal ideation was found in the overall cohort of older primary care patients.
• Among patients with CES-D scores >= 16, 14 (4.6%) reported suicidal ideation and received urgent mental health evaluation.
• Patients with suicidal ideation exhibited affective disorders and functional impairment; direct questioning was the most effective identification method.

Conclusions:

• Suicidal ideation prevalence is approximately 1% in older primary care patients, rising to nearly 5% among those with significant depressive symptoms.
• Directly inquiring about suicidal ideation is essential for identifying at-risk older adults in primary care.
• Early identification and intervention are crucial for managing suicidal ideation in the elderly population.