Suicide

There are currently no national surveillance data of suicide attempts in the United States. Using data from the National Institute of Mental Health Epidemiologic Catchment Area study of five communities, Moscicki and her associates found a much lower prevalence of lifetime suicide attempts for older adults than younger populations. For persons age sixty-five and older, the lifetime prevalence for suicide attempts was 1.1 percent. By comparison, the rate was 4 percent for persons age twenty-five to forty-four. Other community-based studies have estimated lower attempt to completion ratios for older, compared to younger, adults (e.g., Nordentoft et al.). These findings support Conwell and colleagues’s 1998 report that older adults are more intent in their efforts to commit suicide.

Other information about attempted suicide in late life comes from studying the characteristics of older persons recently admitted to a hospital due to the attempt. Draper reviewed twelve studies of later life suicide attempts published between 1985 and 1994. Despite variation in sampling contexts and approaches to measurement, and lack of adequate control groups, he reported several consistent factors associated with attempted suicide in late life: depression, social isolation, and being unmarried. The degree to which physical health was a risk factor was unclear. In some studies it appeared to play a major role, while in another only about one-third of the patients identified health as a salient factor.

The relationship between hopelessness and suicide attempts in later life was examined by studying the course of hopelessness in depressed patients (Rifai et al., 1994). Patients who had attempted suicide in the past had significantly higher hopelessness scores than nonattempters during both the acute and continuation phases of psychiatric treatment. Moreover, a high degree of hopelessness persisting after the remission of depression in older patients appeared to be associated with a history of suicidal behavior. This study by Rifai and her associates also suggested that a high degree of hopelessness may increase the likelihood of premature discontinuation of treatment and lead to future attempts or suicide. One prospective study of older depressed inpatients followed over a year found that 8.7 percent attempted suicide (Zweig and Hinrichsen). Patients who attempted suicide were more likely to have an incomplete remission of depression, history of suicide attempts, and familial interpersonal strain compared to those who did not attempt within the one year follow-up.