OBJECTIVES To examine how physical health (PH) crises preceding suicide differ from late midlife (50-64 years) to older age (≥65 years). METHODS Using 2022-2023 National Violent Death Reporting System-Restricted Access Data, we analyzed suicide decedents aged ≥ 50 with a PH problem as a precipitant (N = 11,796) and reviewedct 2 coroner/medical examiner and law enforcement narratives for those with a PH crisis. RESULTS PH crises increased with age, occurring in 3.7% of decedents aged 50-64, 8.5% aged 65-74, 12.3% aged 75-84, and 12.8% aged ≥ 85. Terminal illness and pain were principal health correlates of PH crisis status. Pain was less frequently implicated with increasing age, whereas functional limitations, heart disease, falls, and dementia were generally more prevalent in older groups. Narratives showed that crises in late midlife more often involved occupational and economic consequences, whereas those in older age involved threatened autonomy, dependence, perceived burdensomeness, and care transitions. CONCLUSIONS PH crises became more prominent with advancing age, while the illnesses and contexts differed from late midlife through older age. CLINICAL IMPLICATIONS Healthcare professionals should assess suicide risk when older adults experience serious or worsening PH problems. Suicide prevention approaches should adopt collaborative safety planning including both health services and age-appropriate care support.
OBJECTIVES To examine within-person associations between nighttime sleep duration and mental well-being among older Chinese adults. METHODS We analyzed four waves of the China Health and Retirement Longitudinal Study (CHARLS; 2011-2018) using individual fixed-effects linear regressions with wave fixed effects and individual-clustered standard errors. Outcomes were CES-D-10 depressive symptoms and reverse-coded life satisfaction. Sleep was modeled continuously and categorically, with main categories of ≤6 h, >6 to <9 h, and ≥9 h; sensitivity models used ≤ 5 h, >5 to <9 h, and ≥9 h. RESULTS Among observations with valid CES-D-10 data, 36.74% met the ≥10 screening threshold. Each additional hour of sleep was associated with lower CES-D-10 scores (β = -0.305) and higher life satisfaction (β = 0.015). Compared with the main reference range, short sleep was associated with higher CES-D-10 scores (β = 0.846) and lower life satisfaction (β = -0.046). Long-sleep estimates varied by specification and outcome. CONCLUSIONS Shorter nighttime sleep duration, particularly sleep in the operational short-sleep category, was associated with poorer mental well-being within individuals over time. CLINICAL IMPLICATIONS Usual sleep duration can inform mood and sleep assessment but should not substitute for evaluation of sleep quality or sleep disorders.
