Predicting reasons for living among chronically ill and depressed middle aged and older adults enrolled in a randomized clinical trial

The American older adult population is rapidly growing and projected to double by 2030. There is high proportion of completed suicides in later life subsequent to several biopsychosocial variables. Medical populations, particularly Chronic Obstructive Pulmonary Disease (COPD) and Heart Failure (HF), have greater risk of depression, suicidality, and lower quality of life. Current geropsychology suicide research tends to focus on risk factors, a deficit approach. In contrast, the present study utilized a strength-based approach to study late life suicide by predicting life sustaining cognitions, reasons for living (RFL). This study explored the influence of physical health related quality of life (HRQOL) and depression on RFL in a sample of 75 depressed and chronically ill middle aged and older adults enrolled in a randomized clinical trial. The results indicate insignificant relationships between demographic variables (e.g. age, gender, and illness type) and reasons for living. Despite the statistically significant negative correlations between depression and physical and mental HRQOL at baseline and week five, only week five depression significantly predicted RFL (Β = -1.369, ΔR2 = .063, p= .034), after the effects of age and baseline depression were held constant. In conclusion, the present study supports integrative primary care modalities of treatment for late life depression and highlights the importance of incorporating protective factors in suicide risk assessments. Future research should consider utilizing population specific instruments and alternative medical and social variables.