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Background Although there have been numerous studies of suicidality in younger populations with schizophrenia, there have been no studies focused on community-dwelling older adults with schizophrenia. This study provides data on the prevalence of suicidality and factors associated with previous suicide attempts among a mixed racial sample of older persons with schizophrenia living in New York City. Methods The schizophrenia group consisted of 198 persons aged ≥55 years who developed schizophrenia before age 45. A community comparison group (n=113) was recruited using randomly selected block-groups. Fifteen predictor variables of lifetime suicide attempts based on a risk model of suicide in schizophrenia were identified. Results Persons in the schizophrenia group had a significantly higher prevalence of current and lifetime “suicidality” (i.e., wants to be dead, suicidal thoughts, or suicide attempts) when compared to the community group (current: 10% versus 2%; lifetime: 56% versus 7%) as well as past suicidal attempts (30% versus 4%). Within the schizophrenia group, in logistic regression analysis, 2 variables were significantly associated with lifetime suicidal attempts: current syndromal depression and higher scores on the Traumatic and Victimization Scale. Conclusions The data confirmed that in later life, persons with schizophrenia continue to have a higher prevalence of suicidality than their age peers in the community. Our findings underscore the importance of monitoring for suicidality in this age group. The relative paucity of risk factors means that practitioners can more easily focus their therapeutic efforts on at-risk individuals.

The number of persons aged 55 and older with a diagnosis of schizophrenia is projected to double over the next 20 years. A tripartite classification system of early-onset schizophrenia, late-onset schizophrenia, and very-late-onset schizophrenia-like psychosis has been proposed. This column reviews recent findings on the outcome and associated features of clinical symptom and social well-being categories for older adults with early-onset schizophrenia.

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