Korean J Fam Pract 2019; 9(6): 546-553  https://doi.org/10.21215/kjfp.2019.9.6.546
Association between Multimorbidity and Suicidal Ideation in Korean Elderly
Yo Han Han1,2, Jun-Hyun Yoo1,*, In Young Cho1
1Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; 2Graduate School of Biomedical Convergence, College of Medicine, Chungbuk National University, Cheongju, Korea
Jun-Hyun Yoo
Tel: +82-2-3410-2440, Fax: +82-2-3410-0388
E-mail: drjohn.yoo@samsung.com
ORCID: http://orcid.org/0000-0002-0344-5123
Received: October 12, 2019; Accepted: November 22, 2019; Published online: December 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Recent studies have reported that multimorbidity is associated with suicidality. The objective of this study was to evaluate the association between physical multimorbidity and suicidal ideation (SI) among the elderly.
Methods: A total of 6,712 subjects aged over 65 years without depression were analyzed from the Korea National Health and Nutrition Examination Survey databases (2010–2013, 2015). In our study, multimorbidity was defined as being diagnosed with two or more chronic diseases. The association between multimorbidity and SI was evaluated through multiple logistic regression analysis.
Results: Through our analysis, 40.7% of participants had multimorbidity and the 14.6% had SI. Multimorbidity was associated with suicidal ideation when adjusting for sociodemographic and health behavior covariates (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.14–1.55). However, no association between multimorbidity and SI existed after adjusting for additional health status factors. In subgroup analyses performed according to education level and health status, the risk of SI was high in subjects with multimorbidity only in those with below elementary school education level (OR, 1.36; 95% CI, 1.14–1.63). Further subgroup analysis indicated that the group without stress and the group without depressiveness both showed association of multimorbidity with SI (OR, 1.27; 95% CI, 1.02–1.59; OR, 1.28; 95% CI, 1.05–1.56).
Conclusion: The study findings suggest that elderly with multimorbidity must be identified, evaluated, and managed for SI with special attention to those with education levels below elementary school. Physicians should also focus on assessing mental health status in the case of multimorbidity in the elderly without depression.
Keywords: Suicidal Ideation; Multimorbidity; Aged; Korea
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