Abstract
The first aim of this study was to provide prevalence suicidal feelings over time (past week, past month, past year and lifetime) in a population-based sample of old to very old adults without dementia. Does prevalence change with rising age? The second aim was to examine the fluctuation of suicidal feelings over time. How does this coincide with depression status? Data were derived from the Gothenburg H70 Birth Cohort Studies (the H70 studies) which are multidisciplinary longitudinal studies on ageing. A representative sample of adults in Gothenburg, Sweden with birth years 1901-1944 were invited to take part in a longitudinal health study on ageing and participated at one or more occasions during 1986-2014. The sample consisted of 6668 observations originating from 3972 participants without dementia between the ages of 70 and 108, including 1604 participants with multiple examination times. Suicidal feelings were examined during a psychiatric interview using the Paykel questions (life not worth living, death wishes, thoughts of taking own life, seriously considered taking life, attempted suicide). Prevalence figures for suicidal feelings of any severity were as follows: past week 4.8%, past month 6.7%, past year 11.2% and lifetime 25.2%. Prevalence rates increased with age in the total group and in women but not in men. Suicidal feelings were common in participants with concurrent major or minor depression, but over a third of the participants who reported suicidal feelings did not fulfil criteria for these diagnoses nor did they present elevated mean depressive symptom scores. The majority of participants consistently reported no experience of suicidal feelings over multiple examination times, but fluctuation was more common in women compared with men. Suicidal feelings in late-life are uncommon in individuals without depression indicating that such behaviour is not a widespread, normative phenomenon. However, such feelings may occur outside the context of depression.
Highlights
With a growing share of older adults in today’s society and a particular rapid increase in the number of very old persons, population ageing has become a repeatedly described social and economic challenge facing policy makers all over the world (Eurostat, 2015; United Nations Department of Economic and Social Affairs – Population Division, 2017).In most regions of the world, suicide rates are highest in persons above 70 years of age (World Health Organization, 2014)
We presented age group-specific prevalence rates of suicidal feelings over four decades of ageing, demonstrating an increasing prevalence of suicidal feelings with increasing age
The vast majority of participants consistently reported no experience of suicidal feelings over multiple examination times, fluctuation in experiencing suicidal feelings was an important finding
Summary
A wealth of studies have investigated correlates of suicide and death ideation in older people, indicating that complex interactions between biological, psychological, social, environmental and cultural factors may contribute to the risk for late-life suicide (Fassberg et al, 2012; World Health Organization, 2014; Fassberg et al, 2016; Stolz et al, 2016; Rymo et al, 2017; Conejero et al, 2018), with depression being a solid correlator (Corna et al, 2010; Vasiliadis et al, 2012; Park et al, 2014; Holmstrand et al, 2015; Stolz et al, 2016). Prevalence figures and risk factors for late-life suicidal behaviour are often presented for entire cohorts with an age range over several decades. Studies of late-life suicidal ideation and behaviours are seldom sex-stratified, as highlighted in recent research reviews conducted by the International Research Group on Suicide in Older Adults
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