title: Does disability predict attempted suicide in the elderly? A community-based study of elderly residents in Shanghai, China.
abstract: OBJECTIVE
  Disability, which has been proved to be associated with suicide and suicidal ideation, has received little attention in relation to suicidal attempts among the elderly. The aim of this study was to explore the influence of disability on attempted suicide within this demographic.
  
  
  METHODS
  A multi-stage cluster sample of 8399 residents aged 60 or more was investigated from 15 communities in Shanghai, China. Disability was measured using the Lawton instrumental activities of daily living (IADL) scale.
  
  
  RESULTS
  The prevalence of attempted suicide in the elderly was 0.75%. Specific IADL disabilities, including shopping (OR = 3.01, 95% CI = 1.56-5.81), preparing meals (OR = 4.12, 95% CI = 2.12-8.00), housekeeping (OR = 2.48, 95% CI = 1.01-6.06), doing laundry (OR = 2.82, 95% CI = 1.09-7.35), using transport (OR = 3.10, 95% CI = 1.36-6.99) and medical care (OR = 4.41, 95% CI = 2.10-9.17), were significantly and independently associated with attempted suicide in the elderly. The presence of at least one such disability was associated with an almost threefold increase in the attempted suicide rate, and the presence of five or more IADL disabilities was associated with an approximate fivefold increase in the attempted suicide rate.
  
  
  CONCLUSIONS
  Specific IADL disabilities, such as preparing meals or dealing with medical care, may be significant predictive factors for risk of suicidal attempts among the elderly. Therefore, elderly people with certain disabilities should be considered for suicide prevention interventions and should be supported in IADL as much as possible.
authors.affiliation: a Department of Health Services Management , The Second Military Medical University , Shanghai , China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: b Shanghai Medical Information Center , Shanghai , China.|c Shanghai Health Development Research Center , Shanghai , China.
authors.forename: Hansheng
authors.initials: H
authors.lastname: Ding
authors.affiliation: a Department of Health Services Management , The Second Military Medical University , Shanghai , China.
authors.forename: Peng
authors.initials: P
authors.lastname: Su
authors.affiliation: a Department of Health Services Management , The Second Military Medical University , Shanghai , China.
authors.forename: Guangfeng
authors.initials: G
authors.lastname: Duan
authors.affiliation: c Shanghai Health Development Research Center , Shanghai , China.
authors.forename: Rong
authors.initials: R
authors.lastname: Chen
authors.affiliation: a Department of Health Services Management , The Second Military Medical University , Shanghai , China.
authors.forename: Junrui
authors.initials: J
authors.lastname: Long
authors.affiliation: b Shanghai Medical Information Center , Shanghai , China.|c Shanghai Health Development Research Center , Shanghai , China.
authors.forename: Lixia
authors.initials: L
authors.lastname: Du
authors.affiliation: b Shanghai Medical Information Center , Shanghai , China.|c Shanghai Health Development Research Center , Shanghai , China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Xie
authors.affiliation: b Shanghai Medical Information Center , Shanghai , China.|c Shanghai Health Development Research Center , Shanghai , China.|d Shanghai Population and Development Research Center , Shanghai , China.
authors.forename: Chunlin
authors.initials: C
authors.lastname: Jin
authors.affiliation: a Department of Health Services Management , The Second Military Medical University , Shanghai , China.
authors.forename: Chaoqun
authors.initials: C
authors.lastname: Hu
authors.affiliation: a Department of Health Services Management , The Second Military Medical University , Shanghai , China.
authors.forename: Zixue
authors.initials: Z
authors.lastname: Sun
authors.affiliation: e Community Health Service Center, Jiangning Street, Jing'an District , Shanghai , China.
authors.forename: Lingling
authors.initials: L
authors.lastname: Gong
authors.affiliation: a Department of Health Services Management , The Second Military Medical University , Shanghai , China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Tian
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D002681:China / Q000453:epidemiology; D055812:Community-Based Participatory Research; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
keywords: Chinese; attempted suicide; community-based; disability; elderly