Fassberg et al reported physical illnesses, such as cancer, neurologic disorder, pain, liver disease, genital disorders, or rheumatoid disorders, along with physical disability as strongly associated with SA in older people. In contrast, physical conditions increased, as well as bereavement. The same decrease was found for legal and financial stressors and relationship problems. In the same study, prevalence of any psychiatric treatment and disorder also decreased with age. 6 Lifetime SA prevalence was higher in young-olds (65–74 years) compared to middle-olds (75–84 years). 5 Furthermore, within older adults who died by suicide, SA prevalence decreased with age. Hawton and Harriss found that the ratio of deliberate self-harm to suicide varied from 200 among teenagers to 10 in individuals aged 60 and older. 4 Conversely, several studies have shown a decrease of SA during life course. 3 Moreover, the rate of suicide increases with age among people older than 60. Furthermore, the chronic care model should be adapted for the treatment of older people with long-term conditions in order to improve the treatment of depressive disorders and the prevention of suicidal thoughts and acts.Īlthough suicide attempts (SA) are more frequent among adolescents and young adults, 1 older men and women show the highest suicide rate in almost all countries, 2 reaching 48.7/100,000 in the USA for white men (more than four times the nation’s age-adjusted rate of 11.1/100,000) and 140/100,000 in rural China for men. Our main findings emphasize the need to integrate specific stress factors, such as feelings of social disconnectedness, neurocognitive impairment or decision making, as well as chronic physical illnesses and disability in suicide models and in suicide prevention programs in older adults. We also aimed to approach the problem of euthanasia or physician-assisted suicide in older adults. The aim of our narrative review was to provide a critical evaluation of recent findings concerning specific risk factors for suicidal thoughts and behaviors among older people: psychiatric and neurocognitive disorders, social exclusion, bereavement, cognitive impairment, decision making and cognitive inhibition, physical illnesses, and physical and psychological pain. A PubMed literature search was performed to identify most recent and representative studies on suicide risk factors in older adults. Specific health conditions and stress factors increase the complexity of the explanatory model for suicide in older adults. Suicide rates increase during the life course and are as high as 48.7/100,000 among older white men in the USA. Suicidal behavior in older adults (65 years old and over) is a major public health issue in many countries.
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