Objectives To study the association between physical illness and suicide in elderly people. Design Case-control with illness determined from interviews with relatives of people who committed suicide and with control participants and from medical records. Setting Gothenburg and two surrounding counties (210 703 people aged 65 years and over). Participants Consecutive records of people who had committed suicide and had undergone forensic examination (46 men, 39 women) and living control participants from the tax register (84 men, 69 women). Main outcome measures Physical illness rated in 13 organ systems according to the cumulative illness rating scale-geriatrics; serious physical illness (organ category score 3 or 4); overall score for burden of physical illness. Results Visual impairment (odds ratio 7.0, 95% confidence interval 2.3 to 21.4), neurological disorders (3.8, 1.5 to 9.4), and malignant disease (3.4, 1.2 to 9.8) were associated with increased risk for suicide. Serious physical illness in any organ category was an independent risk factor for suicide in the multivariate regression model (6.4, 2.0 to 20.0). When the sexes were analysed separately, serious physical illness was associated with suicide in men (4.2, 1.8 to 9.5) as was high burden of physical illness (2.8, 1.2 to 6.5). Such associations were not seen in women, possibly because of the small sample size. Conclusions Visual impairment, neurological disorders, and malignant disease were independently associated with increased risk of suicide in elderly people. Serious physical illness may be a stronger risk factor for suicide in men than in women.

Mental disorder and family discord were the two major risk factors for suicide among elderly men and women.

Background: Seniors aged 75 and above have the highest suicide rates of all age groups in most industrialized countries. However, research concerning risk factors for suicide in the old elderly is sparse. Objective: The purpose was to determine predictors for suicide among the old elderly (75+). Data concerning the young elderly (65–74 years) are shown for comparison. Methods: 85 consecutive cases of suicide that occurred in western Sweden and 153 control persons with the same sex, birth year, and zip code as the suicide cases were randomly selected from the tax register. The old elderly group included 38 cases and 71 controls; the young elderly group included 47 cases and 82 controls. Data concerning the suicide cases were collected through interviews with close informants; controls were interviewed in person. The interview included questions on past-year life events and mental and physical health. Medical records were reviewed for cases and controls. The Cumulative Illness Rating Scale – Geriatrics was used to rate illness burden. Results: Family conflict, serious physical illness, loneliness, and both major and minor depressions were associated with suicide in the 75+ group. Economic problems predicted suicide in the younger but not in the older elderly. Old elderly suicide victims with depression (major or minor) were less likely to have received depression treatment than their younger counterparts. Conclusions: Better recognition and treatment of both major and minor depression should constitute an important target for the prevention of suicide in the old elderly. Intervention studies with large numbers of senior participants are sorely needed.

We investigated the importance of magnesium and calcium in drinking water in relation to morbidity and mortality from acute myocardial infarction. Cases were men and women 50-74 years of age living in 18 Swedish municipalities who had suffered an acute myocardial infarction some time between October 1, 1994, and June 30, 1996. Controls were randomly selected from the same study base. We interviewed the surviving cases (N = 823) and controls (N = 853), focusing on risk factors for acute myocardial infarction. We collected individual data on drinking water levels of magnesium and calcium. We classified subjects by quartile of water magnesium or calcium levels. The total number of cases was similar in the four quartiles. The risk of death was 7.6% (95% confidence interval = 2.1-13.1) lower in the quartile with high magnesium levels (> or = 8.3 mg/liter). The odds ratio for death from acute myocardial infarction in relation to water magnesium was 0.64 (95% confidence interval = 0.42-0.97) for the highest quartile relative to the three lower ones. Multivariate analyses showed that other risk factors were not important confounders. For calcium, this study was inconclusive. The data suggest that magnesium in drinking water is associated with lower mortality from acute myocardial infarction, but not with the total incidence.

The relation between death from acute myocardial infarction and the level of magnesium in drinking water was examined using mortality registers and a case-control design. The study area comprised 17 municipalities in the southern part of Sweden that have different magnesium levels in the drinking water. Cases were men in the area who had died of acute myocardial infarction between ages 50 and 69 years during the period 1982-1989 (n = 854). The controls were men of the same age in the same area who had died from cancer during the same time period (n = 989). In both groups, only men who consumed water supplied from municipal waterworks were included in the study. The subjects were divided into quartiles according to the drinking water levels of magnesium and calcium and the quotient between magnesium and calcium. The odds ratios for death from acute myocardial infarction in the groups were inversely related to the amount of magnesium in drinking water. For the group with the highest levels of magnesium in drinking water, the odds ratio adjusted for age and calcium level was 0.65 (95 percent confidence interval 0.50-0.84). There was no such relation for calcium. For the magnesium/calcium quotient, the odds ratio was lower only for the group with the highest quotient. These data suggest that magnesium in drinking water is a important protective factor for death from acute myocardial infarction among males.