Suicides in late life

Abstract

Suicide in late life is an enormous public health problem that will likely increase in severity as adults of the baby boom generation age. Data from psychological autopsy studies supplemented with recent studies of suicidal ideation and attempts point to a consistent set of risk factors for the spectrum of suicidal behaviors in late life (suicide ideation, attempts, and deaths). Clinicians should be vigilant for psychiatric illness (especially depression), physical illness, pain, functional impairment, and social disconnectedness. Recent advances in late-life suicide prevention have in common collaborative, multifaceted intervention designs. We suggest that one mechanism shared by all preventive interventions shown to reduce the incidence of late-life suicide is the promotion of connectedness. For the clinician working with older adults, our recommendation is to not only consider risk factors, such as depression, and implement appropriate treatments but to enhance social connectedness as well.

Fig. 1

The Interpersonal Theory of Suicide applied to late life. Note that the three inner colored circles represent the three key constructs posited to cause suicide according to the Interpersonal Theory of Suicide. The five boxes represent key risk factors for late-life suicide derived from psychological autopsy studies. The dotted lines from these risk factors to one of the inner circles indicate hypothesized psychological mechanisms (derived from the Interpersonal Theory of Suicide) whereby risk factors elevate the risk of late-life suicide. All these factors and mechanisms are couched within the context of personality, neurobiology, life events, and culture