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Obiective: The objective of the present study was to assess the prevalence of suicidal ideation in an elderly rural Chinese population and to evaluate association between suicidal ideation and potentially related factors.Methods: This was a community-based, cross-sectional study conducted in November 2010.The target population was adults aged 60 years and older residing in rural communities of Macheng County, Hubei Province, China.We first selected 3 rural districts randomly from 19 districts of Macheng County.Then we selected 17 villages randomly from all 34 villages in the 3 districts.From the residency registration list in the districts, we identified eligible 2245 people.Elder person with difficulty to communicate, with severe cognitive impairment and admitting in medical care facilities were excluded from this survey.Among eligible subjects, 2025 were responded to the survey.The face-to-face interview was conducted regarding suicidal ideation and socio-demographic and health-related variables by trained interviewer at the home of the elderly.Associations were evaluated using univariate and multivariate logistic regression analyses.Results: Of the 2025 eligible participants, 144 (7.1%) reported having suicidal ideation in the past 12 month.The prevalence of suicidal ideation among the male and female elderly was 6.9% and 7.2%, respectively.However occurrence was not significantly related to gender.Univariate logistic analysis identified chronic physical illnesses, lack of perceived social support, lack of life satisfaction, lack of source of income, religious brief, depressive symptoms, domestic abuse, and family history of suicide as significantly associated with thoughts of suicide.When multivariate logistic regression analysis was performed controlling for factors that were significantly associated with thoughts of suicide on univariate analysis, chronic physical illnesses, lack of perceived social support, life satisfaction, religious brief, suffering domestic abuse, and family history of suicide were still significantly associated with suicidal ideation.Conclusion: The prevalence of suicidal ideation among the elderly rural Chinese population is higher than in Western countries.In the rural community setting, screening for family history of suicide, lack of social support, and domestic abuse, may provide a practical and effective means of identifying elders at high risk of suicide.