Effects of Health-Related Quality of Life on Suicidal Ideation and Depression among Older Korean Adults: A Cross-Sectional Study

Objective The aim of this study was to investigate the prevalence of depression and suicidal ideation among older Korean adults and the predictors of suicidal ideation. Methods We analyzed data from 5,604 Koreans aged 65 or older collected by the Korea National Health and Nutrition Examination Survey in 2012-2016, an annual national, cross-sectional, epidemiologic study of the Korean population. A chi-square test was used to assess differences in socio-demographic characteristics by suicidal ideation. Psychological variables, self-rated physical health, and the five dimensions of the Korean version of the EQ-5D (EuroQoL) were compared between four subgroups categorized according to the presence/absence of suicidal ideation and depression. Multiple logistic regression was used to estimate the predictive power of health-related quality of life variables, as well as physical and psychological factors regarding suicidal ideation. Results Overall, 11.5% of the sample reported suicidal ideation, and 20.0% of the suicidal ideation group were diagnosed with depression. Respondents with suicidal ideation had significantly lower levels of health-related quality of life than those without suicidal ideation. EQ-5D self-control (OR=1.42), anxiety/depression (OR=2.32), depression (OR=2.07), and self-rated physical health (OR=1.36) were found to significantly predict suicidal ideation. Conclusion Suicidal ideation without depression was prevalent among older Koreans. Self-control, anxiety/depression of EQ-5D, self-rated physical health, and depression predicted suicidal ideation. Interventions to screen older Koreans for early detection of suicide risk and prevention strategies should consider evaluating each EQ-5D dimension.