Risk factors for suicidal behaviour in late-life depression: A systematic review

Abstract

BACKGROUND Suicide is a leading cause of preventable death worldwide, with its peak of maximum incidence in later life. Depression often puts an individual at higher risk for suicidal behaviour. In turn, depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing. AIM To gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults, and to examine the effects of depression treatment to tackle suicide behaviour in this population. METHODS A systematic review of empirical studies, published from 2000 onwards, was conducted. Suicidal behaviour was addressed considering its varying forms ( i.e. , wish to die, ideation, attempt, and completed suicide). RESULTS Thirty-five papers were selected for review, comprising both clinical and epidemiological studies. Most of studies focused on suicidal ideation (60%). The studies consistently pointed out that the risk was related to depressive episode severity, psychiatric comorbidity (anxiety or substance use disorders), poorer health status, and loss of functionality. Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults. Finally, the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response. Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms. CONCLUSION To sum up, common and age-specific risk factors seem to be involved in suicide development in depressive older adults. A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well.

Effect of intergenerational exchange patterns and intergenerational relationship quality on depressive symptoms in the elderly: An empirical study on CHARLS data

“…Other control factors, including demographics, economic conditions, and health status, also affect the presence of depressive symptoms in the elderly ( 31 , 32 ). In this paper, the three types of control variables were introduced, among which demographic variables included age, gender, and marital status; economic condition variables included working status, education, residence, and medical insurance status; and health status variables included the presence of chronic diseases and disabilities.…”

Loneliness and mood disorders: consequence, cause and/or unholy alliance?

“…In addition to 'reinforcing' each other, when they are present together, depression and loneliness can increase the risk of particularly concerning symptoms or health consequences, having a joint negative health impact. The co-presence of high levels of both depression and loneliness increases likelihood of self-harm and suicidal ideation across different age groups [25,[34][35][36][37][38].…”

Socio-economic-cultural factors and depression in the elderly in suicidal ideation and suicidal intention

“…The main risk factor of suicide is the presence of a depressive disorder unnoticed or insufficiently treated (FERNANDEZ-RODRIGUES et al, 2022). There is no unequivocal symptomatology that can indicate effective suicidal intent; however, suicide attempts are more frequent in the elderly than in other age groups.…”