Suicide and the elderly

Abstract

Impending demographic changes mean that the proportion of the elderly in the population will increase. Suicide rates increase with age. The literature on elderly suicide, with emphasis on methodology, cross-national rates and trends, correlates, cultural factors, location and method, attempted suicides and prevention, is critically reviewed in this paper.

Comparison of rates of suicide methods used by the elderly in England and Wales

“…The finding that rates for violent methods of suicide were higher in older males than females, have also been previously observed (Shah and De, 1998;Harwood et al, 2000;Hoxey and Shah, 2000;Tadros and Salib, 2000;Salib and Green, 2003). However, this study also found that older men had higher rates of drowning than older women, which although supporting the findings of Hoxey and Shah (2000), was contrary to the results of Harwood et al (2000), who found that this method was more common in older women than men.…”

“…Although rates for poisoning by antiepileptic, sedative-hypnotic, anitparkinsonism and psychotropic drugs were higher in older women than men, these result were non significant. In addition, for all other forms of suicide by poisoning the rates were higher for older men than women, but again these were non significant.The finding that overall rates were significantly higher in older than younger men was as expected, as traditionally suicide rates increase with ageing (Shah and De, 1998). A similar trend was found for females, although these did not reach statistical significance.…”

“…Previous studies have observed that suicide rates in older people have declined in both sexes over the 12-year period (1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996) and 24-year period in England and Wales (Hoxey and Shah, 2000;Shah et al, 2001), although the rates are still considerably higher than those among younger adults. It is believed that a better understanding of the methods used by older people for suicide may lead to the development of targeted preventative strategies, which are expected to meet the challenge of sustaining this observed decline in suicide rates among older people over time in England and Wales (Lindesay, 1991;Dennis and Lindesay, 1995).Traditionally, elderly men use more violent methods of suicide, including hanging, strangulation and suffocation, shotgun and larger firearm discharge, and sharp objects (Shah and De, 1998 Hoxey and Shah, 2000;Tadros and Salib, 2000;Salib and Green, 2003). Older women tend to use more passive methods of suicide, in particular drug overdose (Hoxey and Shah, 2000;Harwood et al, 2000;Tadros and Salib, 2000).…”

Elderly suicide rates: the importance of a non-linear relationship with distal risk and protective factors

“…Risk factors attributable to age, period, and cohort membership can independently influence suicide rates at a given age and given time in a given birth cohort (Shah and De, 1998). Suicide rates in individuals born in a particular cohort are peculiar to that cohort -the cohort effect.…”

“…Proximal risk and protective factors have generally been examined either descriptively in case-series of elderly suicide victims (Shah and De, 1998) or analytically in case-control studies (Waern et al, 2003). Such studies have primarily examined linear relationships between suicide and proximal risk and protective factors.…”