There is but one truly serious philosophical problem, and that is suicide Albert CamusElderly people have a higher risk of completed suicide than any other age group worldwide. 1 Despite this, suicide in elderly people receives relatively little attention, with public health measures, medical research, and media attention focusing on younger age groups.2 We outline the epidemiology and causal factors associated with suicidal behaviour in elderly people and summarise the current measures for prevention and management of this neglected phenomenon. Sources and selection criteriaWe searched Medline and the Cochrane database for original research and review articles on suicide in elderly people using the search terms "suicide", "elderly", and "older". Dispelling the myths (Greek and otherwise)From time immemorial, suicidal feelings and hopelessness have been considered part of ageing and understandable in the context of being elderly and having physical disabilities. The Ancient Greeks tolerated these attitudes in the extreme and gave elderly people the option of assisted suicide if they could plead convincingly that they had no useful role in society. Such practices were based on the assumption that once an individual had reached a certain age then they no longer had any meaningful purpose in life and would be better off dead. Although not as extreme, ageist beliefs in modern, especially industrialised, societies are based on similar assumptions. Sigmund Freud echoed such views, while suffering from incurable cancer of the palate:It may be that the gods are merciful when they make our lives more unpleasant as we grow old. In the end, death seems less intolerable than the many burdens we have to bear. The burden of suicide is often calculated in economic terms and, specifically, loss of productivity. Despite lower rates of completed suicide in younger age groups, the absolute number of younger people dying as a result of suicide is higher than that for older people because of the current demographic structure of many societies.1 Younger people are also more likely to be in employment. Therefore the economic cost of suicide in younger people is more readily apparent than that in older people.The burden of suicide should not, however, be measured solely in such reductionist terms, and the extent of the real burden on families and communities from suicide in elderly people cannot be overemphasised. Furthermore, the ageing of populations worldwide means that the absolute number of suicides in elderly people is likely to increase. Epidemiology of suicidal behavioursOne model of the suicidal process is that suicidality exists along a continuum (figure). Following this model, the epidemiology of suicidal behaviours in elderly people can be described broadly under the headings of suicidal ideation, attempted suicide, and completed suicide.The prevalence of hopelessness or suicidal ideation in elderly people varies from 0.7-1.2% up to 17% in different studies, depending on the strictness of criteria used.3 w2 A universal find...

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Findings provide compelling evidence that training and access to diagnostic services are only two of several different structural and ideological obstacles that GPs encounter when attempting to diagnose dementia. Future educational supports for GPs need to be developed which concentrate on these areas.

This cross-sectional study demonstrated an association between loneliness and specific aspects of cognition independent of depression, social networks and other demographics. The mechanism for this association is unclear and warrants further investigation.