Journal
INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY
Volume 36, Issue 5, Pages 647-656Publisher
WILEY
DOI: 10.1002/gps.5463
Keywords
aged; deliberate self‐ harm; eyesight; memory; mental disorders; older adults; social network; suicide; suicide attempt
Categories
Funding
- National Health and Medical Research Council of Australia [1136128, 1122544, 1158707]
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In older adults, health issues, psychological distress, and social support are associated with suicidal behavior. Participants with small social networks had elevated rates of subsequent self-harm and suicide.
Objective To assess associations between physical, mental, and social well-being and suicide and self-harm in a community-based sample of older adults. Methods Using a cohort design, questionnaire data from 102,880 individuals aged 65 years or older living in New South Wales, Australia during 2006-2009 were linked to hospital and cause-of-death databases until 2017. Poisson regressions obtained adjusted incidence rate ratios (IRRs). Results One hundred nine suicides and 191 deliberate self-harm (DSH) events occurred. Compared to those reporting excellent/good overall health, older adults reporting fair overall health had higher suicide rates (IRR = 2.8, 95% confidence interval: 1.8-4.4). Also, suffering from physical limitations was associated with higher rates of suicide. A fair versus excellent/good memory was associated with higher rates of suicide (IRR = 2.0, 1.3-3.3). Male erectile dysfunction was linked to self-harm (IRR = 2.8, 1.0-7.7). Suicide rates were elevated with baseline Kessler-10 scores of 20-50 versus 10-15 (IRR = 5.0, 2.9-8.9); the corresponding IRR for DSH was 2.9 (1.8-4.8). Elevated rates were observed for both self-reported depression and anxiety. Poor versus excellent/good quality of life was associated with suicide (IRR = 4.3, 1.7-10.7) and achieving less than desired to due to emotional problems was linked to self-harm (IRR = 1.8 1.3-2.4). Rates of suicide ande DSH were lower in those with >= 5 people to depend on versus one (suicide: IRR = 0.5, 0.3-0.9; DSH: IRR = 0.5, 0.3-0.7). Conclusions Older adults experiencing health problems, including those relating to overall health or memory, and those with psychological distress had elevated rates of suicidal behavior. Rates of subsequent self-harm and/or death by suicide were elevated in participants with small social networks.
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