Lifetime Suicidality Among Older Mexican Adults: Depression, Sexual Trauma and Cardiometabolic Disease in a Secondary Analysis of the ENSANUT Continua 2023 Survey

Abstract

INTRODUCTION: Suicidal ideation and attempts among people who reach old age are a priority public health issue, yet are understudied in Latin America. Geriatric syndromes such as depression and sarcopenia, along with psychosocial adversities and chronic diseases, may shape suicide risk over the life course. OBJECTIVE: To estimate the prevalence of lifetime suicidal ideation and attempts among older Mexican adults and to identify their association with depression, sarcopenia, sexual trauma, and chronic cardiometabolic disease using national data. METHODS: We conducted a secondary analysis of the 2023 ENSANUT Continua survey database. Lifetime suicidal ideation and attempts were assessed through structured questionnaires. Variables included depressive symptoms (CES-D-7), risk of sarcopenia (SARC-F), history of sexual abuse, and a composite count of chronic cardiometabolic and other diseases. Logistic regression models were applied to estimate adjusted odds ratios (AOR) with 95% confidence intervals. Models for suicidal ideation and suicide attempts were adjusted for sociodemographic, clinical and psychosocial covariates, including depressive symptoms, multimorbidity, sarcopenia risk and history of sexual abuse; functional status was analysed only in bivariate comparisons because it was assessed in a subsample. RESULTS: A total of 1570 adults aged 60 or older were included, of whom 1569 had complete data for multivariable analyses. Overall, 5.0% (95% CI: 4.0-6.2) reported lifetime suicidal ideation, and 2.4% (95% CI: 1.7-3.3) reported lifetime suicide attempts. Lifetime suicidal ideation was independently associated with younger age, metropolitan (vs. rural) residence, higher depressive symptom scores, a greater number of comorbidities and a history of sexual abuse. Lifetime suicide attempts were independently associated with previous suicidal ideation, a higher number of chronic diseases and responding 'does not remember' to the question on childhood sexual abuse. In bivariate comparisons, hypertension, myocardial infarction and chronic kidney disease were more frequent among participants with suicide attempts. Associations of SARC-F with suicidality attenuated after adjustment. CONCLUSIONS: Among older Mexican adults, lifetime suicidality is closely linked to depressive symptoms, sexual trauma, and cardiometabolic disease. These findings describe patterns of co-occurrence between lifetime suicidal behaviour and late-life health profiles, underscoring the need for integrated mental and physical health assessment in geriatric care.