Older adults have the highest risk of death by suicide in the United States. Improving our understanding of the factors that lead to increased risk of suicide in older adults will greatly inform our ability to prevent suicide in this high-risk group. Two studies were conducted to test the effect of perceived burdensomeness, a component of the interpersonal-psychological theory of suicide (Joiner, 2005), on suicide ideation in older adults. Further, gender was examined as a moderator of this association to determine if perceived burdensomeness exerted a greater influence on suicide ideation in males. The results of these studies suggest that perceived burdensomeness accounts for significant variance in suicide ideation, even after predictors such as depressive symptoms, hopelessness, and functional impairment are controlled. Gender did not moderate the association. The implications of these findings for treatment of older adults with suicide ideation and elevated suicide risk are discussed.

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Overweight and obese hypertensive patients can greatly benefit from high adherence rates for lifestyle modifications. The objectives of this paper were to investigate how patients' weight status affected physicians' recommendations of lifestyle modifications and patients' adherence after they received the recommendations. The patients were adults (18 þ years of age) with hypertension (prehypertension, Stage I and Stage II hypertension). The National Health and Nutrition Examination Survey (NHANES) 1999-2000 was used. Weight status was categorized as normal/underweight, overweight and obese. Physicians' recommendations of and patients' adherence to lifestyle modifications (weight control, exercise, sodium intake reduction, alcohol intake reduction) were examined using descriptive and multivariate analyses, controlling for weight status, hypertension stage, comorbidities and demographic characteristics. About 57.0% of the US adult population in 1999-2000 had prehypertension, Stages I or II hypertension. Among the hypertensive adults, 30.3% were normal/underweight, 32.6% were overweight and 37.2% were obese. We found that physicians were more aggressive in recommending lifestyle modification for obese patients. In contrast, obese hypertensive patients were not found to be more likely than normal/underweight patients to adhere to lifestyle modification recommendations. In addition, adherence rates for sodium and alcohol consumption reduction were higher than that for either exercise or weight control. In conclusion, more aggressive approaches should be taken by physicians to educate obese patients about the benefits of lifestyle modifications and to improve adherence to enhance the effects of antihypertensive medications.

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