Suicidal ideation in family caregivers of patients with dementia, cancer, stroke, and ischemic heart disease

BACKGROUND: Suicidal ideation among caregivers has drawn increasing attention. However, most prior studies have examined single diseases and provide limited comparative evidence. Furthermore, evidence focusing on family caregivers of community-dwelling adults with chronic diseases remains limited. Using nationally representative data of community-dwelling adults, we assessed the association between caregiving and suicidal ideation across four high-burden conditions: dementia, cancer, stroke, and ischemic heart disease (IHD). METHODS: We conducted a cross-sectional analysis using 2007-2021 data from the Korean National Health and Nutrition Examination Survey (KNHANES). Patients with the four target diseases were identified and linked to family members through a household identification number. The final sample included 7,025 caregivers and 66,872 non-caregivers. Suicidal ideation was assessed using a standardized questionnaire. Multivariable logistic regression and subgroup analyses were performed. RESULTS: Suicidal ideation was reported by 6.1% of non-caregivers and 6.9% of caregivers (adjusted odds ratio [aOR] = 1.18;95%CI = 1.05-1.32). Compared to non-caregivers, the risk of suicidal ideation was highest among caregivers of patients with IHD (aOR = 1.46;95%CI = 1.18-1.80) and patients or sibling caregivers (aOR = 2.21;95%CI = 1.34-3.62), caring for female patients (aOR = 1.18;95%CI = 1.03-1.36) and these caring for younger patients (< 60 years). In subgroup analysis, the association was notably stronger among older and female caregivers than male caregivers. CONCLUSIONS: Mental health support should be tailored to disease and caregiving role. Interventions are especially needed for parents and spouses under high psychological burden. Policies must prioritize screening and access to mental health care for vulnerable caregivers.