title: A cross-sectional study on risk factors and their interactions with suicidal ideation among the elderly in rural communities of Hunan, China.
abstract: OBJECTIVE
  To identify risk factors, and their interactions, for suicidal ideation among the elderly in rural communities of Hunan and to provide some scientific basis for suicide prevention.
  
  
  METHODS
  A cross-sectional survey was conducted among the elderly in rural communities in China's Hunan Province. Thirteen areas were selected by multi-staged cluster random sampling, and 1887 rural elders were investigated via face-to-face interviews.
  
  
  METHODS
  Measures included sociodemographic information, suicidal ideation, activities of daily living (ADL), major depression disorder (MDD), drinking, stressful life events and social support. Non-conditional logistic regression was preformed to explore the influencing factors for suicidal ideation, and additive interaction was used to analyse the interaction between risk factors.
  
  
  RESULTS
  Incidence of suicidal ideation among the elderly was 14.5% (95% CI 12.9% to 16.1%) in rural communities of Hunan. The independent influencing factors for suicidal ideation were annual personal income (OR 3.14; 95% CI 2.15 to 4.59), MDD (OR 17.04; 95% CI 11.91 to 24.39), chronic diseases (OR 2.99; 95% CI 1.84 to 4.85) and ADL (OR 2.00; 95% CI 1.37 to 2.94). Additive interactions were detected between MDD and ADL with a relative excess risk of interaction (RERI) of 21.18 (95% CI 5.47 to 36.89), and between MDD and annual personal income with an RERI of 35.00 (95% CI 9.00 to 61.00).
  
  
  CONCLUSIONS
  The independent risk factors for suicidal ideation are annual personal income (≤2200 CNY), MDD, chronic diseases and disabled ADL status. MDD has additive interactions with ADL and annual personal income. These findings have significant implications for the prediction and prevention of suicidal behaviours.
authors.affiliation: Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Huilan
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Lulu
authors.initials: L
authors.lastname: Qin
authors.affiliation: Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Jinhong
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Luo
authors.affiliation: Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Mi
authors.initials: M
authors.lastname: Hu
authors.affiliation: Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: Shuiyuan
authors.initials: S
authors.lastname: Xiao
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D000437:Alcoholism; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000150:complications*; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007182:Income; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012424:Rural Population; D012944:Social Support; D013315:Stress, Psychological; D059020:Suicidal Ideation
keywords: elderly; interactions; risk factors; suicide ideation