Suicide Risk Highest in Elderly Men
Kristin J. Addison-Brown, PhD
Although heart disease is the leading cause of death in persons age 65 and over, suicide rates are higher in the US (and most industrialized nations) among persons age 75 and over. Suicide is the 8th leading cause of death in the US overall. Gunshot wound is the most common method, accounting for over 80% of completed suicides.
Late-life suicide may present differently from earlier life in ways that are important for detection of risk and prevention. Risk factors for suicide in older adults include family conflict, serious physical illness, loneliness, depression, and bereavement. The risk of suicide for elderly widowed men is 5x times higher than in married men (adjusting for education, smoking, and other important variables), a trend not seen in elderly women.
Importantly, the elder who attempts suicide often has not been treated for depression previously, although depressed mood is the most common mood disorder in elderly suicides. This may be due in part to older individuals’ reluctance to admit to a sense of depression. Further, unlike their younger counterparts, elder completers of suicide have often never previously attempted suicide. Suicide in later life may therefore also come with less warning. A sense of hopelessness, often seen with late-life challenges and difficulties, is a well-known factor in suicide across all ages and serves as a red flag for suicide risk. Alcoholism is the second most common disorder seen in elderly suicide. Finally, although the elderly attempt suicide less often than younger people, they are unfortunately successful more often, possibly due to the choice of more lethal means (i.e., firearms). In fact, the most common demographic for death by suicide with a firearm is a 73 year-old white male. Other risk factors for suicide across ages include substance abuse, family history of suicidal behaviors, family history of a mood or substance use disorder, previous suicide attempts, and substance intoxication at the time of the attempt.
Knowledge of risk factors is important in suicide prevention. For example, better detection and treatment of depression is clearly associated with decreased suicide. Therefore, closer attention to the mood state of loved ones- and encouragement to seek treatment- should help in prevention of a tragic outcome. Prevention of high-risk situations is also important. As previously mentioned, alcohol (and other substances, less commonly) is associated with suicide and therefore should be limited in those at increased risk for other reasons (e.g., recent bereavement). Removal of means for suicide is also important. While utilization of a substitute method does happen, it is rare. Therefore, removal of the stated, implied, or most likely method is critical for safety.
For most people living in the United States, the most likely method is a firearm. Suicidal individuals often protest at the suggestion that firearms be removed, citing a need to protect themselves. However, it is important to recognize that someone at immediate risk for suicide is at much greater risk of self-inflicted injury than any kind of external harm. In such situations, these individuals will often allow a trusted family member or friend to remove the weapons on a temporary basis. If they will not allow this, other barriers can often be enacted to reduce the likelihood of harm, such as unloading the gun and storing the bullets separately. For other people, this may be dispensing of prescription medication by a trusted family member.
For more information on suicide warning signs, risk prevention, or coping with suicide, please see the following resources:http://www.afsp.org/ http://www.suicidepreventionlifeline.org/ http://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml http://www.cdc.gov/violencePrevention/suicide/
Written byKristin J. Addison-Brown, PhD Owner/Clinical Neuropsychologist NEA Neuropsychology, PLLC Jonesboro, Arkansas