Prevalence Of Suicide In Later Life

Suicide rates for persons aged 65 years and older are higher than for any other age group, and the suicide rate for persons over 85 is the highest of all (Beautrais, 2002; Gallagher-Thompson & Osgood, 1997; Kinsella & Velkoff, 2001; Pearson & Brown, 2000). While depression does not necessarily result in suicide, among older people who make suicide attempts, depression is the most frequent diagnosis (Blank et al., 2001; Pearson & Brown, 2000; WHO, 2001). Suicide rates for men and women tend to rise with age, but are highest for men aged 75 years and above (Kinsella & Velkoff, 2001; WHO, 2001). The high suicide rate among older people, especially older men living on their own, may be partly explained by the fact that older people are more likely to use high-lethality methods of suicide and are much less likely to communicate their intent beforehand (Blank et al., 2001; WHO, 2001). In the UK, drug overdose was the most frequent method of suicide among older people (Draper, 1996). Sadly, although many older people who committed suicide visited their family doctor within 1 month of their act, this did not always result in recognition and treatment (Blank et al., 2001). For example, Caine et al. (1996) carried out a review of the cases of 97 older people who had committed suicide and discovered that while 51 had visited their GP within 1 month prior to their suicide and 47 had been diagnosed with a psychiatric problem, only 19 had received treatment. Caine et al. (1996) reviewed the treatment received by these individuals and concluded that only two had received adequate treatment. The reality is that suicide rates for older people are probably underestimates, as the true cause of death may not always be recorded on the death certificate, either from the reticence of the family doctor reluctant to cause a family distress or because the means of death is uncertain (Pearson & Brown, 2000).

There are two paradoxes about suicide in later life; first, older people are living longer, and yet those surviving longer (especially older men) are more likely than ever to die by their own hand. The second paradox is that it is older women, especially those aged 85 years and above, that are faced with the greatest challenges of ageing, and yet they have much lower rates of suicide than men of the same ages. For anyone working with depressed older adults, a thorough evaluation of suicide risk needs to be made during treatment.

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