Relationship between Activity Limitations, Mental Health, and Suicidal Ideation among Adults Aged 20-64 Years: Using Korea National Health and Nutrition Examination Survey Data

Abstract

Objective: In this study, we examined the relationships among activity limitations, mental health (depression and generalized anxiety disorder), and suicidal ideation among Korean adults aged 20–64 years, and identified those factors associated with suicidal ideation. Methods: In this cross-sectional study, we used 2022 KNHANES data to examine the associations among activity limitation, depression (PHQ-9), anxiety (GAD-7), and suicidal ideation in Korean adults aged between 20 and 64 years of age, focusing on general characteristics, health behaviors, and mental health variables. Data were analyzed using t-tests, chi-square tests, and logistic regression, accounting for the complex survey design. Results: Compared with adults without activity limitations, those with limitations were found to have significantly higher rates of depression (16.8% vs. 3.1%), generalized anxiety disorder (16.0% vs. 3.5%), and suicidal ideation (13.6% vs. 3.1%). After adjusting for covariates, activity limitations remained independently associated with suicidal ideation (AOR = 1.91, 95% CI = 1.19 –3.05), with depression (AOR = 5.15) and anxiety severity showing the strongest associations with suicidal ideation. Adults who performed strength training five or more days per week were found to have lower odds of suicidal ideation compared with those who performed no strength training (AOR = 0.39, 95% CI = 0.19–0.79). Highly perceived stress (AOR = 3.29) and a middle school education or less (AOR = 2.35) were also identified as significant risk factors. Conclusions: Activity limitations are independently associated with suicidal ideation among working-age adults in Korea. Integrated interventions addressing both physical function and mental health, including tailored strength training programs, could make a valuable contribution to preventingsuicide in this population.