The association of objective visual impairment with suicidal ideation and suicide attempts among adults aged ≥50 years in low- and middle-income countries

Smith, Lee and Shin, Jae Il and Barnett, Yvonne A. and Allen, Peter M. and Lindsay, Rosie and Pizzol, Damiano and Jacob, Louis and Oh, Hans and Yang, Lin and Tully, Mark A. and Veronese, Nicola and Koyanagi, Ai (2021) The association of objective visual impairment with suicidal ideation and suicide attempts among adults aged ≥50 years in low- and middle-income countries. British Journal of Ophthalmology. ISSN 1468-2079

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Official URL: http://dx.doi.org/10.1136/bjophthalmol-2021-318864

Abstract

Background: There is currently limited literature on the association between visual impairment and suicidal thoughts and behaviours, especially among older adults from low/middle-income countries (LMICs). Thus, we aimed to investigate the associations of objectively measured distance visual impairment with suicidal ideation and suicide attempts among adults aged ≥50 years from six LMICs and to identify potential mediators. Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health were analysed. Objective distance visual acuity was measured using the tumbling E logMAR chart, and vision impairment was categorised as none, mild, moderate and severe. Self-reported information on past 12-month suicidal ideation and suicide attempts was also collected. Multivariable logistic regression and mediation analysis were conducted. Results: Data on 34 129 individuals aged ≥50 years (mean (SD) age, 62.4 (16.0) years; 47.9% men) were analysed. After adjustment for potential confounders, compared with no visual impairment, severe visual impairment was significantly associated with suicidal ideation (OR=9.50; 95% CI=2.47 to 36.52). Moderate and severe visual impairment were significantly associated with a 2.22 (95% CI=1.14 to 4.35) and 11.50 (95% CI=1.44 to 91.88) times higher odds of suicide attempts, respectively. Disability, poor self-rated health, mobility and loneliness explained 14.0%, 9.3%, 7.2% and 6.3% of the association between moderate/severe visual impairment and suicide attempts, respectively. Conclusion: Interventions to reduce suicidal ideation and suicide attempts among older adults with visual impairment in LMICs are required, targeting identified mediators, while using tested strategies for suicide prevention per se in LMICs may yield beneficial outcomes.

Item Type: Journal Article
Keywords: Suicide, Suicidal Ideation, Vision Impairment
Faculty: Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 26 Apr 2021 10:28
Last Modified: 10 Jun 2021 10:48
URI: https://arro.anglia.ac.uk/id/eprint/706520

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