Abstract
Rates of suicide in older adults may be higher than reported due to poor understandings of presentation of suicide ideation in this group. The objectives of this paper were to (i) review current measurement tools designed for older adults to detect suicide ideation and (ii) assess their psychometric properties. We used a systematic review approach to identify measurement tools developed specifically for older adults without cognitive decline or impairment. Ten articles that reported on a total of seven different measurement tools were identified. These included tools that focused on resiliency to suicide and those that measured risk of suicide behavior. There was wide variation across the articles: some were adaptations of existing scales to suit older populations, others were developed by authors; they varied in length from four to 69 items; a range of settings was used, and there was a mix of self-report and clinician-administered measures. Most displayed good psychometric properties, with both approaches showing similar quality. Limitations in terms of samples, settings, and measurement design are discussed. The case for specific measures for older adults is clear from this review. There appear to be unique factors that should be considered in understanding suicide ideation and behavior among older adults that may not be directly assessed in non-specific measurements. However, there is a need to expand the diversity of individuals included in measurement development to ensure they are appropriate across gender, culture and minority status, and for the views of professionals to be considered.
Highlights
The World Health Organization (WHO, 2019) calculates that one person dies by suicide approximately every 40 seconds worldwide, with those in older age groups being at highest risk
We identified seven individual scales across the ten articles included for review that were a mixture of those measuring negative factors and those focusing on reasons, or wishes, to live
The measures included the Reasons for Living scaleOlder Adults (RFL-OA), reported on by three of the articles included for review: an adaption by Edelstein et al (2009) for older adults, a shortened version developed by Lutz et al, (2019), and one article examining the resiliency to suicide subscale individually (Wadhwa and Heisel, 2019)
Summary
The World Health Organization (WHO, 2019) calculates that one person dies by suicide approximately every 40 seconds worldwide, with those in older age groups (i.e. over 65 years) being at highest risk. Older men are twice as likely to die by suicide compared to women in the same age groups (Barak et al, 2020; Canetto, 2017). Suicide ideation (thoughts, desires, or plans surrounding ending one’s own life) is a recognized risk factor in suicidal behavior (Nock et al, 2008) and increases the risk. Correspondence should be addressed to: Helen Gleeson, Middlesex University, London, NW4 4BT, UK. Received 15 Apr 2021; revision requested 09 Aug 2021; revised version received 07 Sep 2021; accepted 04 Oct 2021
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