Chronic medical conditions and wishes to die among older primary care patients.
OBJECTIVE
To determine the prevalence of wishes to die and the medical correlates of wishes to die among primary care patients aged 65 years and older.


METHODS
Three-hundred and fifty-five adults with and without significant depressive symptoms who were screened in primary care offices and invited to participate completed a baseline in-home assessment. Participants were interviewed using standardized measures of medical conditions, functional status, and psychological status. Thoughts of death and wishes to die were assessed with standard questions from the Composite International Diagnostic Interview (CIDI) Depression Section.


RESULTS
The weighted point prevalence of thoughts of death was 9.7% and 6.1% for the wish to die. Several medical conditions were associated with a wish to die, for example myocardial infarction (MI). In multivariate models that adjusted for potentially influential characteristics, the association between a history of MI and the wish to die remained statistically significant (odds ratio (OR) = 3.32, 95% confidence interval (CI) (1.26, 8.75).


CONCLUSIONS
Thoughts of death and a wish to die are common in older primary care patients and were more likely among persons with chronic medical conditions. Persons with a history of myocardial infarction may be particularly vulnerable to a wish to die.
Kim
Yeowon A
YA
University of Pennsylvania, Philadelphia 19104, USA.
Bogner
Hillary R
HR
Brown
Gregory K
GK
Gallo
Joseph J
JJ
D000203:Activities of Daily Living / Q000523:psychology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D002908:Chronic Disease / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening; D009042:Motivation; D009203:Myocardial Infarction / Q000523:psychology; D011320:Primary Health Care; D012044:Regression Analysis; D012803:Sick Role; D013405:Suicide / Q000523:psychology*; D013850:Thinking