Mental Disorders, Cognitive Impairment and the Risk of Suicide in Older Adults

Abstract

More than 600 million people are aged 60 years and over are living in the world. The World Health Organization estimates that this number will double by 2025 to 2 billion older people. Suicide among people over the age of 60 is one of the most acute problems. The factors strongly associated with suicide are mentioned: physical illnesses, such as cancer, neurologic disorder, pain, liver disease, genital disorders, or rheumatoid disorders. Moreover, neurologic conditions, especially stroke, may affect decision-making processes, cognitive capacity, and language deficit. In addition to dementia, the most common mental disorders are mood and anxiety disorders. A common symptom of these disorders in the elderly is cognitive impairment. This study aimed to present the relationship between cognitive impairment due to dementia, mood disorders and anxiety, and an increased risk of suicide among older people. Dementia is a disease where the risk of suicide is significant. Many studies demonstrated that older adults with dementia had an increased risk of suicide death than those without dementia. Similar conclusions apply to prodromal dementia Depression is also a disease with a high risk of suicide. Many researchers found that a higher level of depression was associated with suicide attempts and suicide ideation. Bipolar disorder is the second entity in mood disorders with an increased risk of suicide among the elderly. Apart from suicidal thoughts, bipolar disorder is characterized by high mortality. In the group of anxiety disorders, the most significant risk of suicide occurs when depression is present. In turn, suicide thoughts are more common in social phobia than in other anxiety disorders. Suicide among the elderly is a serious public health problem. There is a positive correlation between mental disorders such as dementia, depression, bipolar disorder, or anxiety and the prevalence of suicide in the elderly. Therefore, the elderly should be comprehensively provided with psychiatric and psychological support.

Physical multimorbidity, suicidal ideation, and suicide attempts among adults aged ≥50 years from low‐ and middle‐income countries

“…30 In turn, cognitive decline (e.g., impairments in cognitive control, executive function, problem-solving) make it difficult to cope with life problems functionally, and thus, can increase the risk of suicidal thoughts and behavior. 47 An interesting finding in the present study is that the multimorbidity/suicidal ideation and suicide attempt relationship was observed to be stronger in males than females. Although the reason for this can only be speculated, this may be related with factors such as differences in disease profiles or likelihood of receiving antidepressants between women and men.…”

Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

“…Depression, anxiety, and substance abuse are the most common conditions found in older adults ( 5 – 8 ), although many other syndromes, such as sleep disorders, apathy, and agitation/aggression have also been frequently observed ( 9 ). The evolution of mental disorders is disastrous to patients and commonly involves disability and suicide ( 10 – 12 ), in addition to its high economic costs ( 12 ).…”

Prediction of Antidepressant Efficacy by Cognitive Function in First-Episode Late-Life Depression: A Pilot Study

“…In addition, the prediction of antidepressant efficacy could improve treatment sensitivity, which would help reduce unnecessary drug exposure ( 6 ). Treatment-resistant depression is detected promptly and antidepressant therapy can be optimized as early as possible ( 7 ) which could improve the patient’s quality of life, reduce the medical burden, and even reduces the risk of suicide of patients ( 8 ).…”