Cognitive frailty and suicidal ideation among Chinese rural empty-nest older adults: Parent-child geographic proximity as a possible moderator?

• DOI: 10.1016/j.jad.2020.12.111
• Publication Date: 2020-12-29T07:11:56Z
• Authors: Dan Zhao; Jie Li; Peipei Fu; Wenting Hao; Yemin Yuan; Caiting Yu; Zhengyue Jing; Yi Wang; Chengchao Zhou
• Keywords: China; Suicidal Ideation; 3. Good health; 03 medical and health sciences; Cognition; Cross-Sectional Studies; 0302 clinical medicine; Prevalence; Humans; Cognitive Dysfunction; Parent-Child Relations; Geriatric Assessment; Aged

Few studies explored the relationship between cognitive frailty and suicidal ideation (SI), and whether geographic variable modified this relationship. This study aimed to explore the association between cognitive frailty and SI, and investigated whether parent-child geographic proximity is a moderator in this relationship among Chinese rural empty-nest older adults.A total of 2,549 rural empty-nest older adults (60+) were included in the analysis. SI was assessed using questions from the National Comorbidity Survey. Fried frailty phenotype and Mini Mental State Examination were used to measure cognitive frailty. Moderating effect analysis was performed using logistic regression models and margins plot.The prevalence of SI and cognitive frailty were 10.1% and 6.2% among Chinese rural empty-nest older adults. Participants with cognitive frailty were more likely to suffer from SI (OR=1.16, 95% CI=1.03-2.86). We found that far geographic distance may aggravate this relationship (OR=4.30, 95% CI=1.02-10.24), especially for rural empty-nest older adults whose nearest adult child lived outside the same prefectural city with them.The results cannot be interpreted as causality of the data due to cross-sectional design.Our findings suggested that cognitive frailty was associated with SI and parent-child geographic proximity moderated this relationship. Improving the cognitive frailty of older adults is helpful to prevent SI. Adult children living far away from rural empty-nest older adults should increase intergenerational contact and pay attention to their parents' physical and mental health.