title: Disability in prison activities of daily living and likelihood of depression and suicidal ideation in older prisoners.
abstract: OBJECTIVE
  The study objective was to determine if disability in activities of daily living specific to prison, prison activities of daily living (PADLs), is associated with depression and severity of suicidal ideation (SI) in older prisoners, a rapidly growing population at high risk of suicide.
  
  
  METHODS
  Cross-sectional design using data from a study of prisoners age ≥50 years (N = 167). Depression was operationalized as a score of ≥15 on the 9-item Physician Health Questionnaire (PHQ-9). SI severity was assessed using the Geriatric Suicide Ideation Scale (GSIS). Participants were considered to have PADL disability if they reported any of the following as "very difficult" or "cannot do:" dropping to the floor for alarms, climbing on/off the top bunk, hearing orders, walking while wearing handcuffs, standing in line for medications, and walking to chow. Associations were examined with bivariate tests and with multivariable logistic and linear regression models, and the interaction term gender × PADL disability was tested.
  
  
  RESULTS
  PADL disability was associated with depression and SI severity. There was no main effect of gender on either depression or SI, yet the association between PADL disability and depression was considerably stronger in male than in female older prisoners.
  
  
  CONCLUSIONS
  Identifying older prisoners who have difficulty performing PADLs may help distinguish prisoners who may also be likely to be depressed or experience more severe SI. Furthermore, the association between PADL disability and depression may be particularly salient in older male prisoners. Longitudinal studies are needed as causal inferences are limited by the cross-sectional design. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: University of Connecticut Health Center, UConn Center on Aging, Farmington, CT, USA.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Barry
authors.affiliation: University of Connecticut Health Center, Center for Public Health and Health Policy, Farmington, CT, USA.
authors.forename: Dorothy B
authors.initials: DB
authors.lastname: Wakefield
authors.affiliation: Correctional Managed Health Care, University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Trestman
authors.affiliation: University of Rochester School of Medicine, Rochester, NY, USA.
authors.forename: Yeates
authors.initials: Y
authors.lastname: Conwell
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology*; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011329:Prisoners / Q000523:psychology*; D011330:Prisons / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012307:Risk Factors; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires
keywords: depression; disability; elderly; prisoners; suicidal ideation