Risk and Protective Factors for Suicidal Ideation and Attempts Among Older Adults in California, 2021–2024 Pooled Cross-Sectional Study

Background/Objectives: Older adults have high rates of suicide, but there is little research on age-specific correlates of suicide. The purpose of this study was to examine risk and protective factors for suicidal ideation and attempts across adult and older adult age groups in a racially diverse sample. Methods: Using a cross-sectional analysis of California Health Interview Survey (CHIS) data from 2021 to 2024 (N = 92,397) linked with 2020 CDC/ATSDR Social Vulnerability Index data, the analytic sample was 64,263 California adults selected by address-based sampling and stratified by age: 45–64 years (31.5% of the overall pooled sample), 65–74 years (12.6%), and ≥785 years (9.1%). Outcomes were lifetime suicidal ideation and attempts. Weighted logistic regression models examined risk and protective factors. Results: Approximately 19% of the sample reported lifetime suicidal ideation, and 6% reported lifetime attempts. Psychological distress, childhood exposure to household mental illness or suicidality, and poor self-rated health were risk factors across all age groups, with associations strengthening with age. Among those with lifetime ideation, these risk factors showed even larger associations in older adults. Protective factors included indicators of sociodemographic vulnerability. Conclusions: Suicide risk and protective factors differ substantially across older adulthood. Findings highlight the need for tailored interventions and integration of suicide screening into primary care for older adults.