Health profiles of older nursing home residents by suicidal ideation: A latent class analysis

Int J Geriatr Psychiatry. 2022 Nov;37(11):10.1002/gps.5829. doi: 10.1002/gps.5829.

Abstract

Objectives: Identify the health profiles of older nursing home residents with and without at-admission self-reported suicidal ideation (SI) and examine the association between the identified profiles and self-reported SI at 90 days.

Methods: Using the Minimum Data Set 3.0 and the ninth Patient Health Questionnaire-9 (PHQ-9) item, we identified 15,277 older residents with and 562,184 without self-reported SI at nursing home admission. Latent class analysis, using frailty, cognitive impairment, palliative care index, pain, and remaining PHQ-9 items as indicators, identified health profiles by at-admission SI and the BCH method estimated their association with SI at 90 days.

Results: Profiles identified for residents without at-admission SI were: (1) frail and depressedNoSI (prevalence: 33.9%); (2) frail and severe cognitive impairmentNoSI (38.1%); (3) pre-frailNoSI (28.0%). Residents in the frail and depressedNoSI group had greater odds [adjusted OR: 2.80; 95% Confidence Interval: 2.60-3.00] while those in the frail and severe cognitive impairmentNoSI group had lower odds [aOR: 0.79; 95% CI: 0.71-0.86] of 90-day SI than those in the pre-frailNoSI group. Profiles identified for residents with at-admission SI were: (1) frail and all depressive symptomsSI (22.8%); (2) frail and some depressive symptomsSI (32.2%); (3) frail and severe cognitive impairmentSI (22.9%); (4) pre-frailSI (22.0%). Compared to those in the pre-frailSI group, residents in the frail and all depressive symptomsSI group had greater odds of continuing reporting SI at 90 days [aOR: 1.22; 95% CI:1.09-1.35].

Conclusions: Findings indicated unique health profiles of nursing home residents at higher risk of new onset of or continued SI.

Keywords: cognitive impairment; depression; frailty; latent class analysis; nursing homes; pain; suicidal ideation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Cognitive Dysfunction* / epidemiology
  • Frail Elderly
  • Frailty*
  • Humans
  • Latent Class Analysis
  • Nursing Homes
  • Suicidal Ideation