Understanding Vulnerability to Late-Life Suicide

Abstract

Purpose of Review We review recent evidence on suicide among older adults, examine risk factors contributing to vulnerability to late-life suicide, and summarize possible interventions. Recent Findings We found a steadily increasing rate of late-life suicide in the USA in the past decade. Evidence supporting the integration of depression care managers into primary care for risk reduction is among the strongest to date. Pharmacologic and neuromodulation studies should be considered in geriatric depression complicated by suicidality. Broad societal campaigns about suicide education, as well as active outreach to psychiatric patients after discharge or a suicidal crisis, prevent suicidal behavior. Growing research supports an integrative multidisciplinary approach. Summary Suicide is a complex and multifaceted behavior with numerous casual points for intervention. Access to deadly means, presence of depression, disease, disability, and social disconnection are factors that increase vulnerability. Quality geriatric care, regular screening in primary and emergency care settings, and a multidisciplinary approach are necessary to mitigate risk factors. The COVID-19 pandemic amplifies need for a more aggressive approach.

Three leading suicide methods in the United States, 2017–2019: Associations with decedents' demographic and clinical characteristics

“…Female decedents age under 45 also had higher likelihood of hanging/suffocation use than those age 45–64. High rates of firearm use among the 65+ age group have been well documented, and attributed to a greater intent to die and greater premeditation ( 7 , 9 , 24 , 25 ). However, the higher likelihood of using firearms and/or hanging/suffocation, two highly lethal methods, among decedents age under 45 than those age 45–64 is concerning.…”

COVID-19 pandemic and suicides in Nepal: Way forward for prevention

“…The subconscious pressure and stress induced by such a global event, super-added to the newly found anxiety and supercharged isolation can make for a melting pot of emotions and mental instability which does not only affect individuals with good mental health, but can have a disastrous effect on those with prior mental health diseases and afflictions. The effects of such lockdowns and the COVID-19 pandemic as a whole on the mental health of individuals has now become prevalent as a rising number of suicides have been recorded, the fear is that this may only be an iceberg effect with many more individuals on the verge [6,7]. Various countries and nations have been adversely affected by COVID-19 in various manners spanning from the realm of economics, tourism, development, social wellbeing, enterprise to mental health with increasing warning signs that another epidemic (poor psychosocial and mental health leading to suicides and self-harm) may be stemming from the roots of this global viral pandemic.…”

“…The subconscious pressure and stress induced by such a global event, super-added to the newly found anxiety and super-charged isolation can make for a melting pot of emotions and mental instability which does not only affect individuals with good mental health, but can have a disastrous effect on those with prior mental health diseases and afflictions. The effects of such lockdowns and the COVID-19 pandemic as a whole on the mental health of individuals has now become prevalent as a rising number of suicides have been recorded, the fear is that this may only be an iceberg effect with many more individuals on the verge [ 6 , 7 ].…”

Transcranial Magnetic Stimulation for the treatment of late-life depression: A scoping review

“…Various factors have been associated with late-life depression, of which the most common are chronic medical conditions, painful medical conditions, cognitive impairments, lack of grip strength and lack of instrumental support (Horackova et al, 2019). It has been seen that there is a close association between later-life depression and suicidal behaviour in older people (Ding and Kennedy, 2021). Supportive care, adequate treatment of depression in older people and the use of newer modalities like neuromodulation may help improve later-life depression, quality of life and risk of suicide (Ding and Kennedy, 2021).…”

“…It has been seen that there is a close association between later-life depression and suicidal behaviour in older people (Ding and Kennedy, 2021). Supportive care, adequate treatment of depression in older people and the use of newer modalities like neuromodulation may help improve later-life depression, quality of life and risk of suicide (Ding and Kennedy, 2021).…”