Late-life suicide in an aging world

Leo, Diego De

doi:10.1038/s43587-021-00160-1

Cited by 80 publications

(53 citation statements)

References 67 publications

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“…In contrast, the share of transport accidents decreases with age (6 vs. 10%, respectively). Despite the relatively favorable trends in mortality from falls and transport accidents shown in this study, the risk of death for Polish seniors from each of these causes is higher than the EU average by 23 and 53%, respectively (63).…”

Section: Discussioncontrasting

confidence: 71%

Changes in mortality of Polish residents in the early and late old age due to main causes of death from 2000 to 2019

Burzyńska

Pikala²

2023

Front. Public Health

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PurposeThe aim of the study was to assess mortality trends in Poland between 2000 and 2019 in the early and late old age population (65–74 years and over 75 years).MethodsThe work used data on all deaths of Polish residents aged over 65 years (N = 5,496,970). The analysis included the five most common major groups of causes of death: diseases of the circulatory system, malignant neoplasms, diseases of the respiratory system, diseases of the digestive system and external causes of mortality. The analysis of time trends has been carried out with the use of joinpoint models. The Annual Percentage Change (APC) for each segments of broken lines, the Average Annual Percentage Change (AAPC) for the whole study period (95% CI), and standardized death rates (SDRs) were calculated.ResultsThe percentage of deaths due to diseases of the circulatory system decreased in all the studied subgroups. Among malignant neoplasms, lung and bronchus cancers accounted for the largest percentage of deaths, for which the SDRs among men decreased, while those among women increased. In the early old age, the SDR value increased from 67.8 to 76.3 (AAPC = 0.6%, p > 0.05), while in the late old age group it increased from 112.1 to 155.2 (AAPC = 1.8%, p < 0.05). Among men, there was an upward trend for prostate cancer (AAPC = 0.4% in the early old age group and AAPC = 0.6% in the late old age group, p > 0.05) and a downward trend for stomach cancer (AAPC −3.2 and −2.7%, respectively, p < 0.05). Stomach cancer also showed a decreasing trend among women (AAPC −3.2 and −3.6%, p < 0.05). SDRs due to influenza and pneumonia were increasing. Increasing trends in mortality due to diseases of the digestive system in women and men in the early old age group have been observed in recent years, due to alcoholic liver disease. Among the external causes of mortality in the late old age group, the most common ones were falls.ConclusionsIt is necessary to conduct further research that will allow to diagnose risk and health problems of the elderly subpopulation in order to meet the health burden of the aging society.

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Section: Discussioncontrasting

confidence: 71%

Changes in mortality of Polish residents in the early and late old age due to main causes of death from 2000 to 2019

Burzyńska

Pikala²

2023

Front. Public Health

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“…Depression and suicide in the older adults, 60 years and above, is a major global public health concern [ 6 ]. Suicide in older adults is often attributed to the development of depression due to bereavement or loss of physical health and other comorbidities [ 7 ]. A literature from United States (US) revealed older people make up 12% of the US population, but account for 18% of all suicide deaths secondary to depression and other comorbidities [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with depression among older adults in the case of a low-income country, Ethiopia: a systematic review and meta-analysis

2022

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Background Depression is among the common mental health problems in late-life and an important public health problem. Studies from both middle- and high-income countries have shown that depression is more common among older people than in adolescents. Many older people with depression are overlooked, and fewer efforts are made to mitigate their suffering. Despite depression being a major public health problem among older adults, its overall magnitude, and its main predictors were not determined for the development of appropriate measures. Hence, the objective of this study was, therefore, to estimate the overall prevalence of depression and identify its predictors among older adults in Ethiopia. Methods Available articles were searched by means of different databases using the PRISMA guideline. The quality of the included studies was assessed using a JBI quality appraisal tool. STATA version 14.0 (STATA Corporation, College Station, Texas, USA) statistical software was used to analyze the eligible studies. Subgroup and sensitivity analyses were performed. Cochran’s Q and the I2 test were used to assess heterogeneity. The presence of publication bias was evaluated by using Egger’s test and visual inspection of the symmetry in funnel plots. Result In this meta-analysis, we included 11 articles that assessed 6521 older adults. The overall prevalence of depression among older adults in Ethiopia was 41.85 (33.52, 50.18). The finding was higher in the Oromia region with a prevalence of 48.07% (95% CI: 35.62, 60.51). The finding also demonstrated that being female (AOR = 1.76, 95% CI: 1.17, 2.63), no formal education (AOR = 1.82, 95% CI: 1.03, 3.19), with chronic diseases (AOR = 2.46, 95% CI: 1.00-6.06), and no social support (AOR = 2.01, 95% CI: 1.06, 3.83) were found to be independent predictors of depression in older Ethiopian adults. Conclusion Our systematic review and meta-analysis showed that almost two out of five older adults had depression. Female sex, no formal education, having chronic diseases, and no social support were the independent predictors of depression among older adults in Ethiopia. The study emphasizes that depression among older adults in Ethiopia calls for appropriate screening and interventions to reduce the occurrence and its overwhelming consequences.

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“…Suicidal behavior in later life remains a major public health concern (De Leo, 2022 ; Laflamme et al, 2022 ). Despite the decline in the suicide incidence globally, older adults continue to have the highest rates of suicide worldwide (Naghavi, 2019 ; World Health Organization, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…Prevalence may also be under-estimated and under-recorded due to its unique presentation in later life. Indeed, deaths in older people that result from more passive acts such as the voluntary stopping of eating and drinking (VSED) and suspending/refusing medication are unlikely to be formally investigated as potential suicide deaths or recorded in official statistics (Deuter et al, 2016 ; Hafford-Letchfield et al, 2020 ; De Leo, 2022 ). Unlike other regions of the world, in the United Kingdom, where this study was conducted, suicide is not a criminal act ( Section 2 of the Suicide Act 1961 ), and assisted suicide and euthanasia are illegal (UK Parliament, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

“…A recent conceptual model described several (so-called “gray area”) suicidal behaviors that might be considered unique to suicide expression in later life (Hafford-Letchfield et al, 2022a ). Yet, these expressions are viewed by many as “normal” part of aging, with such behaviors often described as a “rational” response to an age-related decline in physical or mental function (De Leo, 2022 ). The conceptual model presented by Hafford-Letchfield et al ( 2022a ) described how an older adult viewing their life as “completed” could lead to the development of a wish to die and subsequently motivate engagement with a range of behaviors that either are self-destructive (e.g., self-neglect and problematic substance use) or hasten death (e.g., voluntary stopping of eating or drinking and refusing necessary medication).…”

Section: Introductionmentioning

confidence: 99%

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Talking really does matter: Lay perspectives from older people on talking about suicide in later life

Hafford‐Letchfield¹,

Hanna²,

Ellmers³

et al. 2022

Front. Psychol.

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BackgroundThe cumulative body of research on suicidality in later life describes its unique and complex features in older people when compared with that in other population groups. Yet significant gaps exist in how research informs the further development of suitable interventions. The perspectives of older people are also limited in research findings.AimsTherefore, this exploratory study aimed to (1) identify potential barriers and enablers in discussing suicidal thoughts and their expression in later life from the perspectives of lay older people and (2) explore where opportunities might occur in approach, place, relationships, and language with older people to discuss suicidal thoughts and their expression.MethodWe conducted in-depth qualitative individual interviews with 15 people aged 70–89 years. This method helped explore older peoples' own lay perspectives on suicidal thoughts in later life and how these are expressed, and their understanding of where and how people might seek support.ResultsA total of three themes were generated from the dataset: (1) intergenerational and socio-cultural differences in suicide expression, (2) the normalization of suicidal thoughts in later life, and (3) the importance and difficulties of everyday discussion and opportunities to express suicidal thoughts.ConclusionSuicidal thoughts and their expression appear commonly and are normalized in later life yet remain taboo and hidden. The participants revealed how such thoughts and behaviors are typically expressed through colloquial or “off-hand” remarks and comments and the importance of authentic listening. The findings highlight the importance of more informal discussions around these topics and how care professionals, practitioners, and providers might frame opportunities for dialogue with people who may want to access support. Further engagement with community-informed participatory research methods in which older people provide their own perspectives and experiences is important in addressing these gaps. There is a need for co-designing in developing screening, assessment, and signposting outside of clinical settings that can be used in everyday caring relationships with people in later life.

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Late-life suicide in an aging world

Cited by 80 publications

References 67 publications

Changes in mortality of Polish residents in the early and late old age due to main causes of death from 2000 to 2019

Changes in mortality of Polish residents in the early and late old age due to main causes of death from 2000 to 2019

Prevalence and factors associated with depression among older adults in the case of a low-income country, Ethiopia: a systematic review and meta-analysis

Talking really does matter: Lay perspectives from older people on talking about suicide in later life

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