Suicide prevention in older adults

Abstract

Background Suicide among older adults is a multifactorial problem with several interrelated factors involved that vary with age, gender and culture. The number of suicides is highest in those aged 70 years or older in almost all regions of the world. With the increase in life expectancy, and the decrease in mortality due to other causes of death, we could expect the absolute number of older adults' suicide continue increasing. Methods Review of the literature on suicide protective factors of suicide among older adults. Results Improvements on social determinants of health and the timely detection and early treatment of affective disorders are key interventions. Prevention based on community actions and training of gatekeepers may have positive impact. Community programs that promote a sense of usefulness, belonging and that contribute to preserve social integration should be encouraged. Governments should develop the improvement of retirement programs and the development of support systems. The access to general health and mental health services should be facilitated and Primary Care professionals should receive proper training to detect and manage older persons at risk. Actively promoting a culture of coping to different stages of life and to the changes imposed by the advancing of age should form the essential part of a process bringing to better successful aging avenues. Conclusions Suicide prevention in older adults should broaden its focus and pay attention to the many socio‐environmental conditions that may be relevant in older age, especially social isolation, financial security and physical health.

Reliability and Validity of the Quick Inventory of Depressive Symptomatology—Self-Report Scale in Older Adults With Depressive Symptoms

“…Suicide is a sensitive topic to discuss in older adults, particularly in traditional Chinese societies ( 37 ). Older adults tend to harbor passive suicide ideas or plans, which are difficult to ascertain ( 8 , 38 , 39 ). We hypothesize that participants in this study were reluctant to report thoughts of death in the QIDS-SR assessment or to the interviewer.…”

“…The prevalence of depression measured with the Geriatric Depression Scale (GDS) was 16% in older adults in China ( 4 ), and the corresponding figure assessed with the GDS was up to 33% in hospitalized older adults with medical conditions ( 5 ). Depression is associated with increased risk of medical co-morbidities, impaired cognitive and social functioning, poor quality of life, and suicide ( 6 – 8 ). Depression is difficult to identify in older adults due to overlapping symptoms with features of normal aging, such as sleep disturbances and poor appetite ( 9 , 10 ).…”

Is Suicide the End Point of Ageism and Human Rights Violations?

“…This must start with governments providing adequate funding for health and social support services for older persons, policy and law addressing discrimination accompanied by education through the media, equity in resource allocation, and inclusion of older adult voices. 37 Addressing ageism may also be positioned within a public health response to ensure healthcare professionals practice without stigma and discrimination, and receive education about its importance. 37 This involves dispelling societal misconceptions about ageing and emphasising positive aspects of growth, enjoyment and continued activity.…”

“…37 Addressing ageism may also be positioned within a public health response to ensure healthcare professionals practice without stigma and discrimination, and receive education about its importance. 37 This involves dispelling societal misconceptions about ageing and emphasising positive aspects of growth, enjoyment and continued activity. 15,38 For example, retirement can be promoted positively, through symposia which demonstrate positive models of retirement and debunk ageist myths about this phase of life.…”

“…9,11 The specific biopsychosocial factors relevant to suicidal behaviors in older persons must be highlighted. 9,37 Guidelines for the assessment and management of late life suicide in primary care, including appropriate specialist referral processes, 37 will address both equitable access to care for patients and reduce therapeutic nihilism in primary care.…”