Suicide Risk Among the Elderly

(11/28/09)- At a recent conference sponsored by the American Society on Aging, Patrick Arbore, Ed.D cited evidence that suicide is more common among elderly than in any other demographic group. The American Society on Aging is the nation's largest multi disciplinary community of professionals working with and on behalf of older adults.

Dr. Arbore is the founder and director of the Center for Elderly suicide Prevention at the Institute on Aging in San Francisco. In light of this information, the editors of this web site thought it advisable to present as much factual data as is available on suicide in the elderly. The following information comes from and the CDC weekly publication MMWD from July 7, 2006/55(26): 721-724.

(a) Suicide was the 11th leading cause of death for all ages.
(b) Suicides account for 1.4% of all deaths in the US.
(c) More than 32,000 suicides occurred in the US, This is the equivalent of 89 suicides per day, one suicide every 16 minutes or 11.05 suicides per 100,000 population.
(d) Among adults aged 65 or older, there is one suicide every 4 suicide attempts.
(e) The rate of suicide for adults aged 65 years and older was 14.3 per 100,000 population.
(f.)Among males, adults 75 years and older have the highest rate of suicide (rate 37.4 per 100,000 population).
(g) Among females, those in the 40's and 50's have the highest rate of suicide (rate 8.0 per 100,000 population).

Researchers studying suicide behavior have developed a list of risk factors that they believe would be helpful in predicting individuals who would commit suicide.

Risk Factors

(a) Previous suicide attempt (17.95 of suicide victims made previous attempt(s)).
(b) History of depression or other mental disease (most frequently reported diagnoses were depression 81.3%, bipolar disorder 9.9% and schizophrenia 3.3% in 2004)
(c) Alcohol or drug abuse (16.5% had an alcohol dependence problem)
(d) Family history of suicide or violence.
(e) Physical illness (22.1% of suicide victims had a physical illness)
(f) Feeling alone.

These factors should place an older person on a risk continuum for suicide to allow for more informed intervention. Physical illness and feeling alone are a not uncommon factor in the lives of individuals over 65 years of age.

These factors can come into interplay with depression to trigger a suicide attempt. An article in Family Practice News, Nov. 1, 2007 states: "A 1999 report said that major depression played a pivotal role in about 60% of all reported suicide cases and about 80% of suicides in the elderly." (There was no citation for the source of this report).

Another factor that may be correlated with suicide is hopelessness. Hopelessness is a pattern of thinking where individuals believe they are trapped in misery with no expectation of things ever getting better.

R. D. Wetzel in an article ("Hopelessness, depression and suicide intent") that appeared in the Archives of General Psychiatry 1976, 33(9) accessed Nov. 25 2007 concluded that "hopelessness correlated more highly with suicide intent than did depression. The date were regarded as supporting the hypothesis that hopelessness is more closely related to suicide intent than is depression."

Elderly people see physicians not infrequently. Physicians need to be aware that the elderly are less likely to communicate their depression than other younger patients. Depression is a treatable disease.

Dr. Arbore recommends the Geriatric Depression Scale and the Geriatric Hopelessness Scale for assessing the elderly. The Geriatric Depression Scale is in the public domain Physicians can access this sight and obtain a copy of the assessment scale.

Please also see- Failure to Thrive: Sundown Syndrome-Wasting Away


Harold Rubin, MS, ABD, CRC, Guest Lecturer
posted November 28, 2007

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