Suicide and its Prevention among Older Adults

Abstract

A dults aged 65 years or over have high rates of suicide worldwide (1). Approximately 1.3 die by suicide in Canada every day (2). Older adults have long had high suicide rates (3-7); however, programmatic study of geriatric suicide is relatively recent. The prevalence of late-life suicides may increase as the baby boom cohort reaches retirement age (8), given this population's high suicide rates (9,10) and because they are moving into a phase of life in which rates are high. However, baby boomers' strength in getting health care needs met (11) may help to stem that tide. Geriatric suicidology is in Information on funding and support and author affiliations appears at the end of the article. Clinical Implications· Assessment of risk and resiliency and use of standardized measures, if implemented, might improve suicide risk detection. · Combining antidepressants and interpersonal psychotherapy may help resolve suicide ideation. · Mental health providers are encouraged to collaborate with older patients ' primary care providers, social service workers, and family and other gatekeepers and to employ mental health outreach efforts. Limitations· Risk-factor research has been limited by the statistical rarity of suicide, by the use of diverse inclusion criteria for age, by uncontrolled studies or use of varied control groups, and by little research on resiliency factors. · Few older adult suicide assessment instruments and evidence-based interventions exist. · This review is limited to English-language publications.

Family Connectedness Moderates the Association Between Living Alone and Suicide Ideation in a Clinical Sample of Adults 50 Years and Older

“…We have theorized that protective factors may not simply reflect an absence of suicide risk, but rather may enhance psychological well-being and confer psychological resiliency to mental disorders and risk for suicide [4]. Research is needed assessing whether perceived connectedness to friends, peers, or other supports protects against suicide ideation, and whether participation in social activities, seniors centers, and/or religious activities increases community connectedness and helps protect against death by suicide.…”

“…Much of the research on suicide among middle-aged and older adults has focused on risk factors rather than on factors that protect against death by suicide [4], necessitating research on psychosocial variables that might reduce the likelihood of contemplating suicide when experiencing adversity. Elevated suicide risk is associated with previous self-injury, presence of suicide ideation, mood disorders and other forms of psychopathology, physical illness and functional impairment, personality characteristics such as rigidity and tendency toward emotional instability, and psychosocial problems, stressors, and difficulty adjusting to life transitions [4].…”

“…Elevated suicide risk is associated with previous self-injury, presence of suicide ideation, mood disorders and other forms of psychopathology, physical illness and functional impairment, personality characteristics such as rigidity and tendency toward emotional instability, and psychosocial problems, stressors, and difficulty adjusting to life transitions [4]. Relationship-related markers of suicide risk include being divorced, separated, widowed, or single, living alone, and lacking in social activities [5,6]; having close relationships with family members and others may protect against suicide [6,7].…”

“…Research suggests that perceived social support might decrease risk for suicide. The perception of social support is also negatively associated with late-life suicide ideation, a potentially modifiable risk factor associated with death by suicide [4,18,19]; having poor social support and a limited social network is associated with presence of suicide ideation [20–24]. Rowe and colleagues reported that greater relationship satisfaction and feelings of usefulness are negatively associated with suicide ideation among older homecare recipients, irrespective of social network size [24].…”

Adapting Interpersonal Psychotherapy for Older Adults at Risk for Suicide

“…Theory and research suggest that attention to suicide risk factors may be insufficient to identify and intervene effectively with at-risk individuals. Following the call for a complementary focus on resiliency [20], we demonstrated that older adults expressing greater perceived meaning in life (MIL) and life satisfaction reported significantly less suicide ideation [21]. The positive effect of MIL was most robust at higher levels of depressive symptom severity [22].…”