Investigating Direct and Moderating Effects of Social Connectedness and Perceived Social Support on Suicidal Ideation in Older Adults With Depression: A Prospective Study

Background: Maintaining one's social capital may protect older adults with depression from contemplating suicide, possibly by contributing to overall well-being and mitigating the negative effects of arising difficulties such as worsening mental or physical health. However, it remains unclear whether such protective overall and mitigating effects stem primarily from the size and diversity of one's social network (social connectedness) or from the feeling of being supported by others (perceived social support) and whether these effects persist over time. Methods: In a longitudinal sample of adults with depression ages ≥50 years (N = 287, mean age = 64 years, mean follow-up time = 2 years), with most participants having suicidal ideation (n = 203), zero-inflated negative binomial regression models were used to prospectively evaluate whether social connectedness and perceived social support measured at baseline decreased the presence and severity of suicidal ideation, and whether they moderated the unfavorable effect of baseline depression severity and physical illness on ideation presence and severity at baseline and during short- and long-term follow-ups. Results: In prospective models, both ideation presence and ideation severity decreased with social connectedness (ideation presence: odds ratio = 0.77, SE = 0.10, p = .003; ideation severity: rate ratio [RR] = 0.84, SE = 0.05, p = .005). Perceived social support only decreased ideation severity (RR = 0.64, SE = 0.05, p < .001). No moderation effect with social health measures reached significance. Conclusions: Social connectedness and perceived social support confer lasting protection against suicidal ideation. Clinicians should encourage preventive maintenance of diverse social networks in their middle-age and older patients/clients with depression and help them find adequate social support during acute suicidal crises.