Suicide at 50 years of age and older: perceived physical illness, family discord and financial strain

2004 ◽  
Vol 34 (1) ◽  
pp. 137-146 ◽  
Author(s):  
P. R. DUBERSTEIN ◽  
Y. CONWELL ◽  
K. R. CONNER ◽  
S. EBERLY ◽  
E. D. CAINE
Keyword(s):  
Older Adults ◽  
Mental Disorders ◽  
Suicide Risk ◽  
Control Design ◽  
Case Control ◽  
Physical Illness ◽  
Financial Strain ◽  
Employment Change ◽  
Structured Interviews ◽  
Family Discord

Background. Mental disorders amplify suicide risk across the lifecourse, but most people with mental disorder do not take their own lives. Few controlled studies have examined the contribution of stressors to suicide risk.Method. A case–control design was used to compare 86 suicides and 86 controls aged 50 years and older, matched on age, gender, race and county of residence. Structured interviews were conducted with proxy respondents for suicides and controls.Results. Perceived physical illness, family discord and employment change amplified suicide risk after controlling for sociodemographic covariates and mental disorders that developed [ges ]1 year prior to death/interview. Only the effect of physical illness (OR 6·24, 95% CI 1·28–51·284) persisted after controlling for all active mental disorders.Conclusions. Interventions to decrease the likelihood of financial stress and to help families manage discord and severe physical illness may effectively reduce suicides among middle-aged and older adults.

Suicide risk within one year of cognitive impairment diagnosis in older adults: a nationwide retrospective cohort study

2019 ◽  
Author(s):  
Jae Woo Choi ◽  
Kang Soo Lee ◽  
Euna Han
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mental Disorders ◽  
Suicide Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
One Year

Abstract Background This study aims to investigate suicide risk within one year of receiving a diagnosis of cognitive impairment in older adults without mental disorders. Methods This study used National Health Insurance Service-Senior Cohort data on older adults with newly diagnosed cognitive impairment including Alzheimer’s disease, vascular dementia, other/unspecified dementia, and mild cognitive impairment from 2004 to 2012. We selected 41,195 older adults without cognitive impairment through 1:1 propensity score matching using age, gender, Charlson Comorbidity Index, and index year, with follow-up throughout 2013. We eliminated subjects with mental disorders and estimated adjusted hazard ratios (AHR) of suicide deaths within one year after diagnosis using the Cox proportional hazards models. Results We identified 49 suicide deaths during the first year after cognitive impairment diagnosis. The proportion of observed suicide deaths was the highest within one year after cognitive impairment diagnosis (48.5% of total); older adults with cognitive impairment were at a higher suicide risk than those without cognitive impairment (AHR, 1.89; 95% confidence interval [CI], 1.18–3.04). Subjects with Alzheimer’s disease and other/unspecified dementia were at greater suicide risk than those without cognitive impairment (AHR, 1.94, 1.94; 95% CI, 1.12–3.38, 1.05–3.58). Suicide risk in female and young-old adults (60–74 years) with cognitive impairment was higher than in the comparison group (AHR, 2.61, 5.13; 95% CI, 1.29–5.28, 1.48–17.82). Conclusions Older patients with cognitive impairment were at increased suicide risk within one year of diagnosis. Early intervention for suicide prevention should be provided to older adults with cognitive impairment.

scholarly journals The Mediating Role of Depressive Symptoms, Hopelessness, and Perceived Burden on the Association Between Pain Intensity and Late-Life Suicide in Rural China: A Case–Control Psychological Autopsy Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiali Wang ◽  
Jiahuan Xu ◽  
Zhenyu Ma ◽  
Cunxian Jia ◽  
Guojun Wang ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Depressive Symptoms ◽  
Pain Intensity ◽  
Suicide Risk ◽  
Rural China ◽  
Case Control ◽  
Psychological Autopsy ◽  
Perceived Burden ◽  
The Impact

Background: Few studies have investigated the roles of psychosocial factors such as depressive symptoms and hopelessness on the relationship between pain and suicide with inconsistent results. The study aimed to analyze the impact of pain intensity on suicide death and to estimate the degree to which depressive symptoms, hopelessness, and perceived burden may explain the association in Chinese rural elderly.Methods: Using a 1:1 matched case–control design, we collected data from 242 elderly suicide cases and 242 living community controls by psychological autopsy method in rural China, including sociodemographic characteristics, pain intensity, depression, hopelessness, perceived burden, physical diseases, and social support. Conditional logistic regression was employed to assess the association between pain intensity and completed suicide. Mediation analysis using the KHB method was applied to explore the mediation effects from depressive symptoms, hopelessness, and perceived burden.Results: The result of multivariable logistic regression showed that unemployment [odds ratio (OR) = 5.06, 95% confidence interval (CI): 1.76–14.49], higher levels of hopelessness (OR = 7.72, 95% CI: 3.49–17.10), depressive symptom (OR = 15.82, 95% CI: 4.53–55.25), and severe pain (OR = 3.46, 95% CI: 1.31–9.13) were significantly associated with elevated suicide risk in older adults in rural China. Depressive symptoms, hopelessness, and perceived burden significantly mediated 43.71% of the pain–suicide association (p = 0.020), with 17.39% due to depressive symptoms, 17.63% due to hopelessness, and 8.69% due to perceived burden.Conclusions: Regular screening of pain, depressive symptoms, hopelessness, and perceived burden using simple but sensitive questions or scales for older adults with pain is vital for the prevention and early detection of suicide risk in Chinese rural areas. Moreover, the importance of pain management and psychological interventions targeted on depressive symptoms and hopelessness should be emphasized.

scholarly journals Analisis Faktor Dominan Dalam Perencanaan Rumah Bebas Stunting

Jurnal Teknik ◽  
2021 ◽  
Vol 19 (1) ◽  
pp. 12-22
Author(s):  
Nurmiah ◽  
Rahmayanti
Keyword(s):  
Control Design ◽  
Case Control ◽  
Influential Factor ◽  
Case Group ◽  
Structured Interviews ◽  
Design Data ◽  
Natural Lighting ◽  
The Third ◽  
Lighting Systems ◽  
Existing Data

According to existing data, stunting in Pohuwato Regency prevalence is still high, hence the plan for a stunting-free house is needed. The purpose of this study was to determine the description and the influencing factors to find a strategy for planning a stunting-free house. So that the planning of this stunting-free house can fulfill the needs of village development as well as supporting the Pohuwato government stunting-free program. This research is a retrospective study with a case-control design. Data were collected by semi-structured interviews with mothers of children under five using questionnaire sheets. There are 7 (seven) samples in each case group. From the results of the study, it was found that 3 (three) dominant factors were in the houses of stunting sufferers which could be used as a reference for stunting-free house designs. The most dominant indicator is the land indicator in the OC:BC comparison assessment and the use of the front of the house border. The second indicator that is very dominantly influential is the condition of the sanitation system and the height of the floor slab. The third influential factor is user activity with the assessment of natural lighting systems for stunting-free homes.

Poor social integration and suicide: fact or artifact? A case-control study

2004 ◽  
Vol 34 (7) ◽  
pp. 1331-1337 ◽  
Author(s):  
P. R. DUBERSTEIN ◽  
Y. CONWELL ◽  
K. R. CONNER ◽  
S. EBERLY ◽  
J. S. EVINGER ◽  
...  
Keyword(s):  
Social Interaction ◽  
Mental Disorders ◽  
Social Integration ◽  
Community Involvement ◽  
Employment Status ◽  
Religious Involvement ◽  
Religious Practice ◽  
Case Control ◽  
Structured Interviews ◽  
Social Community

Background. Sociological studies have shown that poor social integration confers suicide risk. It is not known whether poor integration amplifies risk after adjusting statistically for the effects of mental disorders and employment status.Method. A case-control design was used to compare 86 suicides and 86 living controls 50 years of age and older, matched on age, gender, race, and county of residence. Structured interviews were conducted with proxy respondents for suicides and controls. Social integration was defined in reference to two broad levels of analysis: family (e.g. sibship status, childrearing status) and social/community (e.g. social interaction, religious participation, community involvement).Results. Bivariate analyses showed that suicides were less likely to be married, have children, or live with family. They were less likely to engage in religious practice or community activities and they had lower levels of social interaction. A trimmed logistic regression model showed that marital status, social interaction and religious involvement were all associated with suicide even after statistical adjusting for the effects of affective disorder and employment status. Adding substance abuse to the model eliminated the effects of religious involvement.Conclusions. The association between family and social/community indicators of poor social integration and suicide is robust and largely independent of the presence of mental disorders. Findings could be used to enhance screening instruments and identify problem behaviors, such as low levels of social interaction, which could be targeted for intervention.

scholarly journals Suicide risk within 1 year of dementia diagnosis in older adults: a nationwide retrospective cohort study

2020 ◽  
Vol 46 (1) ◽  
pp. E119-E127
Author(s):  
Jae Woo Choi ◽  
Kang Soo Lee ◽  
Euna Han
Keyword(s):  
Older Adults ◽  
Mental Disorders ◽  
Alzheimer Disease ◽  
Suicide Risk ◽  
Cox Proportional Hazards Model ◽  
Dementia Diagnosis ◽  
Suicide Death ◽  
Dementia Patients ◽  
Increased Risk ◽  
Suicide Plan

Background: Although severe dementia could protect against suicide death by decreasing a person’s capacity to implement a suicide plan, patients with early dementia may have better cognition, giving them more sustained insight into their disease and better enabling them to carry out a suicide plan. This study investigated suicide risk in older adults within 1 year of receiving a diagnosis of dementia. Methods: This study used National Health Insurance Service Senior Cohort data and included 36 541 older adults with newly diagnosed dementia (a Mini-Mental State Examination score ≤ 26 and a Clinical Dementia Rating score ≥ 1 or a Global Deterioration Scale score ≥ 3), including Alzheimer disease, vascular dementia and other/unspecified dementia, from 2004 to 2012. We selected older adults without dementia through 1:1 propensity-score matching using sex, age, comorbidities and index year, with follow-up throughout 2013. We estimated adjusted hazard ratios (AHRs) of suicide deaths within 1 year after diagnosis using a time-dependent Cox proportional hazards model. Results: We verified 46 suicide deaths during the first year after a dementia diagnosis. Older adults with dementia had an increased risk of suicide death compared to those without dementia (AHR 2.57; 95% confidence interval [CI] 1.49–4.44). Older adults with Alzheimer disease (AHR 2.50; 95% CI 1.41–4.44) or other/unspecified dementia (AHR 4.32; 95% CI 2.04–9.15) had an increased risk of suicide death compared to those without dementia. Patients with dementia but without other mental disorders (AHR 1.96; 95% CI 1.02–3.77) and patients with dementia and other mental disorders (AHR 3.22; 95% CI 1.78–5.83) had an increased risk of suicide death compared to patients without dementia. Patients with dementia and schizophrenia (AHR 8.73; 95% CI 2.57–29.71), mood disorders (AHR 2.84; 95% CI 1.23–6.53) or anxiety or somatoform disorders (AHR 3.53; 95% CI 1.73–7.21), respectively, had an increased risk of suicide death compared to patients with those conditions but without dementia. Limitations: This study examined only elderly patients in South Korea, a population with a substantially higher suicide rate than the global population. Caution must be exercised when generalizing the results to populations with dissimilar backgrounds. Conclusion: Patients with dementia had an increased risk of suicide death within 1 year after diagnosis compared to those without dementia.

Perceived Burdensomeness Is Key to Suicide Risk Among Older Adults

2011 ◽  
Author(s):  
D. R. Jahn ◽  
K. C. Cukrowicz ◽  
K. Linton ◽  
F. Prabhu
Keyword(s):  
Older Adults ◽  
Suicide Risk ◽  
Perceived Burdensomeness

scholarly journals 346 How Do we Increase Adherence to Home Exercise Programmes? Interviews with Older Adults and Physiotherapists

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Siti Khalijah ◽  
Suzanne Timmons
Keyword(s):  
Older Adults ◽  
Cardiovascular Health ◽  
Home Exercise ◽  
Video Content ◽  
Structured Interviews ◽  
Timed Up And Go ◽  
Convenience Sample ◽  
Improve Compliance ◽  
Exercise Programmes ◽  
Purposive Sample

Abstract Background Regular exercise and physical activity can maintain function and cardiovascular health, and prevent cognitive decline, in older adults. However, studies show that there is often poor adherence to home exercise programmes (HEP). The purpose of this study was to explore how HEP are perceived by both older adults and physiotherapists. Methods A convenience sample of 28 older adults attending outpatient physiotherapy clinics were given an exercise journal to record their adherence to the HEP prescribed by their physiotherapists for six weeks. Subsequently, semi-structured interviews were conducted with a purposive sample, and the corresponding prescribing physiotherapists, to achieve maximal variation in terms of HEP adherence, age and sex. The interviews were audio recorded, transcribed, and simple content analysis performed. Results Fourteen participants returned their exercise journal. Median age was 80; half were female; median Berg Balance Score and Timed-up-and-Go-Test were 49 and 16 seconds respectively. Participants exercised a median 79.8% of the prescribed dose, or 5.6 days per week. Seven older adults were interviewed; about half had a positive attitude towards exercise. They were also moderately positive about their HEP (comments ranged from “doable” and “nothing bad about it” to “enjoyable”). Barriers included time, mood, boredom, remembering to do the HEP, and variable health status. Enablers included simple instructions and design, family encouragement, and sense of achievement. Physiotherapists (n=5) perceived that many older adults aren’t compliant with HEPs, but there was some therapeutic nihilism (“you can’t force them”). Their HEP instructions varied from verbal to written instructions/diagrams; one physiotherapist used individualised video content. Notably, participants with good adherence understood their HEP well in terms of content and purpose, although this may be cause or effect. Conclusion To improve compliance with HEP, healthcare professionals need to take time to motivate the recipient, simplify their instructions, and trouble-shoot potential barriers at the time of prescription.

scholarly journals Plasma acylcarnitines and risk of lower-extremity functional impairment in older adults: a nested case–control study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francisco Félix Caballero ◽  
Ellen A. Struijk ◽  
Alberto Lana ◽  
Antonio Buño ◽  
Fernando Rodríguez-Artalejo ◽  
...  
Keyword(s):  
Older Adults ◽  
Confidence Interval ◽  
Lower Extremity ◽  
Functional Impairment ◽  
Odds Ratio ◽  
Case Control Study ◽  
Case Control ◽  
Community Dwelling ◽  
Control Study ◽  
Long Chain

AbstractElevated concentrations of acylcarnitines have been associated with higher risk of obesity, type 2 diabetes and cardiovascular disease. The aim of the present study was to assess the association between L-carnitine and acylcarnitine profiles, and 2-year risk of incident lower-extremity functional impairment (LEFI). This case–control study is nested in the Seniors-ENRICA cohort of community-dwelling older adults, which included 43 incident cases of LEFI and 86 age- and sex- matched controls. LEFI was assessed with the Short Physical Performance Battery. Plasma L-carnitine and 28 acylcarnitine species were measured. After adjusting for potential confounders, medium-chain acylcarnitines levels were associated with 2-year incidence of LEFI [odds ratio per 1-SD increase: 1.69; 95% confidence interval: 1.08, 2.64; p = 0.02]. Similar results were observed for long-chain acylcarnitines [odds ratio per 1-SD increase: 1.70; 95% confidence interval: 1.03, 2.80; p = 0.04]. Stratified analyses showed a stronger association between medium- and long-chain acylcarnitines and incidence of LEFI among those with body mass index and energy intake below the median value. In conclusion, higher plasma concentrations of medium- and long-chain acylcarnitines were associated with higher risk of LEFI. Given the role of these molecules on mitochondrial transport of fatty acids, our results suggest that bioenergetics dysbalance contributes to LEFI.

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