Identifying predictors of suicidal ideation in community-dwelling older adults with elevated psychological distress over two years.

900 adults (60–74 years) with elevated psychological distress (Kessler Distress 10 Scale; scores>15) participated in a randomized controlled trial of psychological (mental health literacy) and lifestyle-based (physical activity promotion, folate supplementation) interventions for reducing depressive symptoms. Suicidal ideation across a two-year period (five time points) was assessed using an item from the Patient Health Questionnaire.

Demographics, mental and physical functioning (SF-12), and cognitive functioning (Telephone Interview Cognitive Schedule—Modified) were measured.

Intervention type did not predict suicide ideation at any follow up. Those with single or multiple occurrences of suicidal ideation during the two-year period had elevated distress (Single OR=1.06, p=.044; Multiple OR=1.10, p=.001) and depression levels (Single OR=1.07, p=.042; Multiple OR=1.20, p=.001) at baseline, and more likely to be separated from their partner (Single OR=1.81, p=.024; Multiple OR=2.12, p=.016] than those with no ideation. Those with ideation were more likely to experience greater distress at every time point (e.g., 24 months OR=1.18, p=.006) compared to those with no ideation. At 24 months, individuals reporting ideation were significantly more likely to have lower education levels (OR=.81, p=.015), poorer cognitive functioning (OR=.88, p=.036), and greater mental (OR=.89, p=.004) and physical (OR=.92, p=.025) disability.

Elevated distress is consistently related to suicidal ideation. Individuals experiencing suicidal ideation are more likely to be separated, have lower education levels, poorer mental and physical functioning, and poorer overall cognitive functioning than those with no suicidal ideation.