Cluster-derived profiles of suicidal ideation and quality of life among older adults living alone in South Korea

Older adults living alone are often regarded as a vulnerable group exposed to psychosocial risks, yet they are not a homogeneous population. This study aimed to identify distinct clusters of psychosocial well-being within this group and examine key determinants using the World Health Organization Quality of Life (WHOQOL) framework and data from the Intensive Managed Care for Elderly Living Alone (IMCELA) program. A non-hierarchical cluster analysis was conducted based on scores from the Suicidal Ideation Scale (SIS) and the Older People's Quality of Life questionnaire (OPQOL), resulting in three clusters: a baseline cluster with low SIS and low OPQOL, a High Suicidal Ideation cluster, and a High OPQOL cluster. Multinomial logistic regression revealed that higher meal frequency and lower depression scores significantly reduced the likelihood of belonging to the High Suicidal Ideation cluster. Meanwhile, high OPQOL was shaped by a broader set of factors, with perceived social support as the strongest predictor, followed by cognitive functioning, loneliness, and depressive symptoms. These findings suggest that while clinical risk factors such as depression and poor nutrition are key in addressing suicidal ideation, improving quality of life requires comprehensive strategies that enhance emotional and social resources. The results offer practical guidance for developing targeted interventions and policies to support the psychosocial well-being of older adults living alone.