A 50-state survey study of thoughts of suicide and social isolation among older adults in the United States

J Affect Disord. 2023 Aug 1;334:43-49. doi: 10.1016/j.jad.2023.04.038. Epub 2023 Apr 20.


Background: We aimed to characterize the prevalence of social disconnection and thoughts of suicide among older adults in the United States, and examine the association between them in a large naturalistic study.

Methods: We analyzed data from 6 waves of a fifty-state non-probability survey among US adults conducted between February and December 2021. The internet-based survey collected the PHQ-9, as well as multiple measures of social connectedness. We applied multiple logistic regression to analyze the association between presence of thoughts of suicide and social disconnection. Exploratory analysis, using generalized random forests, examined heterogeneity of effects across sociodemographic groups.

Results: Of 16,164 survey respondents age 65 and older, mean age was 70.9 (SD 5.0); the cohort was 61.4 % female and 29.6 % male; 2.0 % Asian, 6.7 % Black, 2.2 % Hispanic, and 86.8 % White. A total of 1144 (7.1 %) reported thoughts of suicide at least several days in the prior 2 week period. In models adjusted for sociodemographic features, households with 3 or more additional members (adjusted OR 1.73, 95 % CI 1.28-2.33) and lack of social supports, particularly emotional supports (adjusted OR 2.60, 95 % CI 2.09-3.23), were independently associated with greater likelihood of reporting such thoughts, as was greater reported loneliness (adjusted OR 1.75, 95 % CI 1.64-1.87). The effects of emotional support varied significantly across sociodemographic groups.

Conclusions: Thoughts of suicide are common among older adults in the US, and associated with lack of social support, but not with living alone.

Trial registration: NA.

Keywords: Cohort; Geriatric psychiatry; Loneliness; Older adults; Social network; Social support; Suicidality; Suicide; Survey.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Female
  • Humans
  • Loneliness / psychology
  • Male
  • Social Isolation* / psychology
  • Suicidal Ideation*
  • Suicide* / psychology
  • United States / epidemiology