Suicide in older adults: a comparison with middle-aged adults using the Queensland Suicide Register

Ahn

Int J Geriat Psychiatry

et al. 2018

Objectives The purpose of this study was to identify distinctive characteristics of old‐old suicide attempters (75 years and older) from young‐old (60‐74 years old) and middle‐aged suicide attempters (45‐59 years old). Methods We included consecutive series of 920 patients aged 45 years and older who had visited the emergency room from 2009 to 2015 because of suicide attempts. They were divided into 3 groups according to age. Information about the suicide attempt and sociodemographic status was gathered through interviews with attempters or caregivers. Chi‐square test and logistic regression analysis were performed to evaluate the differences among the 3 groups. Results We found that old‐old suicide attempters had high intent to die and high medical lethality as a result of the attempt, and illness‐related problems exerted a strong motivational effect on this group. Psychiatric drugs, pesticides, and herbicides were frequently used to attempt suicide. These attempts were less likely to be associated with alcohol consumption compared to other age groups. Conclusion Old‐old suicide attempters have different characteristics, compared with young‐old and middle‐aged counterparts. It is necessary to assess suicide risk and depression when examining patients with physical illness or when prescribing psychotropic drugs. High‐risk groups should be given immediate intervention including psychiatric treatment before they act on high suicide intent.

Section: Discussionmentioning

confidence: 99%

Section: Affiliatedmentioning

confidence: 99%

Sociodemographic and clinical characteristics of old‐old suicide attempters compared with young‐old and middle‐aged attempters

Ahn

Int J Geriat Psychiatry

et al. 2018

“…This observation is consistent with the recently published study out of Spain 11 . Global and national trends and the Parra-Uribe study indicate that suicide rates increase with age and peak in older adults 59 . Using our deep learning methodology with a dataset that includes actual suicides in the Berkshire population may provide important insights into the difference between risk factors for suicide attempt and risk factors for completed suicide.…”

Section: Age-related Feature Differencementioning

confidence: 99%

Development of an early-warning system for high-risk patients for suicide attempt using deep learning and electronic health records

Zheng

Wang²,

Hao

et al. 2020

Transl Psychiatry

Suicide is the tenth leading cause of death in the United States (US). An early-warning system (EWS) for suicide attempt could prove valuable for identifying those at risk of suicide attempts, and analyzing the contribution of repeated attempts to the risk of eventual death by suicide. In this study we sought to develop an EWS for high-risk suicide attempt patients through the development of a population-based risk stratification surveillance system. Advanced machine-learning algorithms and deep neural networks were utilized to build models with the data from electronic health records (EHRs). A final risk score was calculated for each individual and calibrated to indicate the probability of a suicide attempt in the following 1-year time period. Risk scores were subjected to individual-level analysis in order to aid in the interpretation of the results for health-care providers managing the at-risk cohorts. The 1-year suicide attempt risk model attained an area under the curve (AUC ROC) of 0.792 and 0.769 in the retrospective and prospective cohorts, respectively. The suicide attempt rate in the "very high risk" category was 60 times greater than the population baseline when tested in the prospective cohorts. Mental health disorders including depression, bipolar disorders and anxiety, along with substance abuse, impulse control disorders, clinical utilization indicators, and socioeconomic determinants were recognized as significant features associated with incident suicide attempt.

“…5 This age group is less likely to experience somatic illness and healthrelated life events than the older adults. 5 Although the above-cited studies recognise important factors operating in close proximity to suicide, a life-course perspective is also important when planning interventions and evaluating suicide risk in clinical settings since distal factors may play a role in susceptibility to suicide later in life. 3,[6][7][8][9] A study of the 1958 British birth cohort with a follow-up time of 8-49 years reported both prenatal and early childhood risk factors for suicide.…”

mentioning

confidence: 99%

Late-adolescent risk factors for suicide and self-harm in middle-aged men: explorative prospective population-based study

et al. 2019

BackgroundRecent reports show alarmingly high rates of suicide in middle-aged men, yet there are few long-term prospective studies that focus on suicidal behaviour in men in this age group.AimsTo prospectively explore associations of potential risk factors at age 18 with suicide and self-harm in middle-aged men.MethodA population-based Swedish longitudinal cohort study of male conscripts with no history of self-harm at enlistment in 1968–1989 (n = 987 583). Conscription examinations included measures of cognitive performance, stress resilience, psychiatric diagnoses, body mass index (BMI), cardiovascular fitness and muscle strength. Suicides and self-harm at age 45–65 years were identified in the National Hospital Register and Swedish Cause of Death Register. Risks were calculated using Cox proportional hazards models.ResultsLow stress resilience (cause-specific hazard ratio CHR = 2.31, 95% CI 1.95–2.74), low cognitive ability (CHR = 2.01, 95% CI 1.71–2.37) as well as psychiatric disorders and low cardiovascular fitness in late adolescence were associated with increased risk for suicide in middle-aged men. Similar risk estimates were obtained for self-harm. In addition, high and low BMI as well as low muscle strength were associated with increased risk of self-harm. Associations also remained significant after exclusion of men with self-harm before age 45.ConclusionsThis prospective study provides life-course perspective support that psychological and physical characteristics in late adolescence may have long-lasting consequences for suicidal behaviour in middle-aged men, a very large population at heightened risk of suicide.