Smuch Siramongkholkarn¹, Saran Thanapluetiwong¹, Sirintorn Chansirikarnjana¹, Yossawat Suwanlikit², Lee Wei Jun³, Pichai Ittasakul⁴

¹ Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; ² Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand; ³ Department of Internal Medicine, St. Elizabeth’s Medical Center, Brighton MA, USA; ⁴ Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Objective: To examine the prevalence of depression and suicidal thoughts, and their associated factors, among Thai older adults during the COVID-19 pandemic.

Materials and Methods: A cross-sectional telephone survey was conducted between June 20 and July 25, 2021, targeting patients aged 60 years and older who attended a tertiary-care geriatric clinic at Ramathibodi Hospital within the past two years. The Thai version of the Patient Health Questionnaire-9 (PHQ-9) was used to assess depression levels, with the ninth item specifically evaluating suicidal risk. Demographic and clinical data were collected through structured interviews. Data was analyzed using Wilcoxon rank-sum tests, multiple linear regression, and ordered logistic regression models.

Results: Out of 283 individuals, 271 with complete data were included in the analysis. The participants median age was 73 years and 71.6% were female. The prevalence of depression was 14.1%, with 11.9% experiencing mild depression and 2.2% moderate depression. No participants had severe depression. Suicidal thoughts were reported by 1.5% of the participants. Linear regression analysis showed that a higher number of hospitalizations (B=0.75, 95% CI 0.18 to 1.3, p=0.010) and a history of musculoskeletal disease (B=0.81, 95% CI 0.24 to 1.4, p=0.006) were associated with higher PHQ-9 scores. Consistently, logistic regression indicated that hospitalizations (OR 2.91, 95% CI 1.23 to 6.87, p=0.015) and musculoskeletal disease (OR 3.38, 95% CI 1.14 to 10.0, p=0.028) were significant predictors of depressive symptoms.

Conclusion: During the COVID-19 pandemic, addressing depression and suicidal risk has emerged as a critical clinical concern, particularly among older adults. Clinicians must prioritize mental health care for older adults, with special attention to those with high rates of hospital admissions and musculoskeletal complaints.

Received 13 May 2025 | Revised 15 September 2025 | Accepted 22 September 2025

DOI: 10.35755/jmedassocthai.2025.11.884-891-02845