Strategies to Prevent Elderly Suicide: A Delphi consensus study

2021 ◽  
pp. 103985622110642
Author(s):  
Yoram Barak ◽  
Sarah Fortune ◽  
Linda Hobbs ◽  
Gary Cheung ◽  
Gil Zalsman
Keyword(s):  
Older Adults ◽  
Suicide Prevention ◽  
Large Scale ◽  
Later Life ◽  
The Elderly ◽  
Prevention Strategy ◽  
Survey Method ◽  
Public Healthcare ◽  
Delphi Consensus ◽  
Elderly Suicide

Objectives In the next decades, many countries will become ‘ageing societies’. This combined with the current high rates of suicide in later life suggests that many older adults may die by suicide before clinical trials can be conducted to demonstrate the best approaches to prevent late-life suicide. Methods A New Zealand (NZ) ‘expert panel’ has reviewed key considerations for suicide prevention interventions in older adults based on existing evidence, where available, and expert opinion. The key considerations were extracted from the current literature. The Delphi survey method was used to reach consensus for identifying interventions to be recommended as part of a national strategy for older adults’ suicide prevention. Results A set of 20 key recommended considerations are presented. The major addition to existing recommendations is the need for ‘A suicide prevention strategy for the elderly…’ to enhance the national all-ages suicide prevention strategy. Conclusion The recommended statements are offered for consideration by stakeholder groups preparing new interventions, large-scale public healthcare planning and governmental policy.

scholarly journals USING VR FOR NAVIGATION ASSESSMENT IN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S240-S240
Author(s):  
Scott Moffat
Keyword(s):  
Older Adults ◽  
Age Differences ◽  
Large Scale ◽  
Empirical Studies ◽  
Science Research ◽  
Later Life ◽  
Functional Independence ◽  
Spatial Strategies ◽  
Age Related ◽  
Field Of Inquiry

Abstract There has been a long tradition of wayfinding and orienteering studies in humans but these have mostly neglected possible age-related differences in navigation. This field of inquiry is experiencing something of a resurgence of interest due to the development of VR technology which has brought the systematic study of large scale navigation into the laboratory and into the MRI scanning environment. Empirical studies to date identify navigation as an aspect of cognition that is vulnerable to the aging process. Functional and structural neuroimaging studies in humans suggest that age-related changes in the brain’s “navigation circuit” may underlie these behavioral age differences. Older adults also adopt unique spatial strategies and knowledge of these strategy preferences could enlighten both basic science research in spatial cognition and also inform the development of age-specific technological assistance that may extend functional independence of older adults into later life.

scholarly journals Empirically Evaluated Suicide Prevention Program Approaches for Older Adults: A Systematic Review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 859-860
Author(s):  
Vivian Miller ◽  
Noelle Fields ◽  
Ling Xu ◽  
Marta Mercado-Sierra ◽  
Marissa Wallace
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Suicide Prevention ◽  
Full Text ◽  
Later Life ◽  
Prevention Programs ◽  
Health Concern ◽  
Future Research ◽  
Review Of The Literature ◽  
Suicide Prevention Programs

Abstract Suicide is a serious public health concern, particularly for individuals in later life. Studies suggest that greater attention to suicide prevention programs for older adults is needed as well as continued research related to interventions with older adults at risk of attempting suicide. A systematic review of the literature on suicide prevention treatment and effectiveness is fundamental to assessing existing services and developing new programs and practice standards. This systematic review of the literature extends an earlier and well-cited systematic review (1966-2009) by examining articles published between 2009 and 2021 with a focus on what types of empirically evaluated suicide prevention programs effectively prevent and reduce suicidality in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to gather the appropriate extant research and improve reporting accuracy. A three-stage review guided the selection of the articles. At stage one, titles were screened, which excluded 284 articles based on the inclusion criteria. Second, after a full review of each abstract, a final 14 articles remained for full-text review. Lastly, three independent researchers reviewed each of the full-text articles, and six articles were excluded. The final sample includes eight articles (N=8). The articles were categorized into three types of programs: 1) primary and home health care, 2) community-based outreach, and 3) counseling. Following a description of the articles, the authors assessed each study using the GRADE rating system. Findings underscore the critical need for evidence-based suicide prevention programs for older adults. Implications for future research are offered.

Still Feeling Better? Trends in Self-Rated Health of Older Adults in the U.S

2020 ◽  
pp. 016402752096365
Author(s):  
Esther O. Lamidi
Keyword(s):  
Older Adults ◽  
Age Groups ◽  
Later Life ◽  
The Elderly ◽  
Poor Health ◽  
Elderly Persons ◽  
Health Trends ◽  
Self Rated Health ◽  
Middle Aged Adults ◽  
Over Time

Previous analyses showed an overall pattern of improvement in self-rated health of U.S. older adults in the 1980s and the 1990s, but it was uncertain if the declining shares of elderly persons reporting fair or poor health would continue over the next decades. Using the 2000–2018 pooled data from the National Health Interview Survey, this study examined recent trends in self-rated health of adults aged 45 and older. The results showed important variations in self-rated health trends across age groups. Between 2000 and 2018, the shares of adults aged 60 and above reporting fair or poor health declined significantly while self-rated health trends for middle-aged adults worsened over time. Educational and racial/ethnic differentials in self-rated health persisted over time but there were important group variations. To further improve the health of the elderly population, it is important to consider changing health disparities in later life.

Key Considerations for Preventing Suicide in Older Adults

Crisis ◽  
2011 ◽  
Vol 32 (2) ◽  
pp. 106-109 ◽  
Author(s):  
Annette Erlangsen ◽  
Merete Nordentoft ◽  
Yeates Conwell ◽  
Margda Waern ◽  
Diego De Leo ◽  
...  
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Large Scale ◽  
Expert Panel ◽  
Later Life ◽  
Public Health Care ◽  
Care Planning ◽  
International Expert ◽  
Health Care Planning ◽  
Wide Range

Background: The number of older adults is growing rapidly. This fact, combined with the high rates of suicide in later life, indicates that many more older adults will die by their own hands before rigorous trials can be conducted to fully understand the best approaches to prevent late life suicide. Aims: To disseminate key considerations for interventions addressing senior suicidal behavior. Methods: An international expert panel has reviewed and discussed key considerations for interventions against suicide in older adults based on existing evidence, where available, and expert opinion. Results: A set of new key considerations is divided into: universal, selective, and indicated prevention as well as a section on general considerations. Conclusions: The suggestions span a wide range and are offered for consideration by local groups preparing new interventions, as well as large scale public health care planning.

Elderly Suicide in Finland

2000 ◽  
Vol 12 (2) ◽  
pp. 209-220 ◽  
Author(s):  
Kristiina Pitkälä ◽  
Erkki T. Isometsä ◽  
Markus M. Henriksson ◽  
Jouko K. Lönnqvist
Keyword(s):  
Health Care ◽  
Suicide Prevention ◽  
Health Care Services ◽  
The Elderly ◽  
Suicide Mortality ◽  
Elderly Persons ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
Care Services ◽  
Elderly Suicide

Suicide mortality among the elderly is high in most Western countries. We investigated the characteristics of suicide victims 65 years or older in a nationwide psychological autopsy study, the research phase of the National Suicide Prevention Project in Finland. This study population included all completed suicides (N = 1,397, of whom 211 were 65 years or older) that occurred in Finland during a 12-month research period in 1987-1988. The elderly suicide victims were found to have used violent suicide methods more often than the young. Although almost 70% of the elderly persons who had committed suicide had been in contact with health care services during the month before their death, their suicidal intentions were rarely communicated in these contacts. They had been referred to psychiatric services less often than the young, and only 8% had received adequate antidepressive medication. The fact that most elderly suicides have contact with health care services during their final month suggests a potential for suicide prevention. However, the major obstacle to this is the poor recognition of mental disorders and suicidal ideation among the elderly.

Suicide in Later Life

2019 ◽  
Author(s):  
Kim Van Orden ◽  
Caroline Silva ◽  
Yeates Conwell
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Primary Care ◽  
Psychiatric Disorders ◽  
Suicide Prevention ◽  
Later Life ◽  
Universal Prevention ◽  
Prevention Strategies ◽  
Suicide Rates

Suicide in later life is a significant public health problem around the world—a problem that will increase in magnitude in the coming years with the impact of population aging. Adults age 70 and older have higher suicide rates than younger groups worldwide in both lower-income and higher-income countries. While suicide rates tend to increase with age, suicide in later life is not an expected or normative response to stressors that accompany the aging process. Instead, a constellation of risk factors places an older adult at elevated risk for suicide. These factors can be remembered as the Five D’s: psychiatric illness (primarily depression); functional impairment (also called disability, often associated with dependency on others); physical illness (particularly multiple comorbid diseases); social disconnectedness (including social isolation, loneliness, family conflict, and feeling like a burden); and access to lethal (deadly) means. The greatest risk occurs when multiple domains of risk converge in a given individual. Approaches to prevention can address the Five D’s. Given that older adults are reluctant to seek out mental healthcare and that standard primary care practice cannot easily provide it, models of primary care-based integrated care management for mental disorders, including in older adulthood, have been developed, rigorously tested, and widely disseminated. These models play an important role in suicide prevention by integrating treatment for physical and mental illness. Upstream, selective prevention strategies that target disconnectedness—such as engaging older adults as volunteers—may serve to reduce disconnectedness and thereby reduce suicide risk. Universal prevention strategies that involve growing the geriatric workforce may address disability by increasing older adults’ access to medical and social service providers with expertise in improving physical, cognitive, and social functioning, as well as improving quality of life. Addressing ageism and building age-friendly communities that use strategies to integrate older adults into society and promote social participation hold promise as universal prevention strategies. Ultimately, effective suicide prevention strategies for older adults must focus on improving quality of life as well as preventing suicide: strategies such as psychotherapy and medication for psychiatric disorders must be supplemented by prevention strategies for older adults give at all ages in addition to treating psychiatric disorders and suicidal thoughts is needed to address the problem of suicide in later life.

Neurobiology of Depression in Later Life

2013 ◽  
pp. 470-482
Author(s):  
K. Ranga Rama Krishnan
Keyword(s):  
Basal Ganglia ◽  
Vascular Disease ◽  
Neurodegenerative Disorders ◽  
Large Scale ◽  
Later Life ◽  
The Elderly ◽  
Vascular Lesions ◽  
Vascular Component

Large-scale epidemiological work suggest that multiple pathways can lead to depression in the elderly. These pathways include a strong vascular component. The vascular pathway is one that we and others have suggested is critical in the development of depression in the elderly. Vascular disease predisposes to depression, but depression may also heighten the risk for vascular disease and worsen the prognosis of vascular disease. We note that vascular lesions in prefrontal and basal ganglia regions lead to a vulnerability to depression. They do this by disrupting key circuits that regulate mood. Besides vascular factors neurodegenerative disorders also lead to increased depression presumably by similar disruption of pathways.

Future Directions in Late Life Suicide Prevention

2001 ◽  
Vol 42 (1) ◽  
pp. 37-53 ◽  
Author(s):  
Amy Fiske ◽  
Patrick Arbore
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Older Adult ◽  
Suicide Prevention ◽  
Suicide Risk ◽  
Community Outreach ◽  
Late Life ◽  
Community Agencies ◽  
Prevalence Of Depression ◽  
Elderly Suicide

Late life suicide is characterized by less warning, higher lethality, and greater prevalence of depression and physical illness than suicide earlier in the lifespan. Suicidal older adults are more likely to seek help from a physician than through mental health channels, and suicide risk often remains undetected. Hopelessness is a prominent feature in older adult suicide. Traditional suicide hotlines receive few calls from older adults, and staff lack training in working with this age group. Despite the difficulties in preventing older adult suicide, however, opportunities exist. Psychotherapeutic and psychopharmacological treatments for depression may be effective in suicidal older adults, although they have not yet been widely tested. Community agencies with specialized programs for older adults show promise. Results are presented from the evaluation of one such agency, the Center for Elderly Suicide Prevention. After receiving agency services, hopelessness improved among clients but not in a comparison group. There were no significant changes in depressive symptoms or life satisfaction. Recommendations for future preventive efforts include: use of medical contacts to screen for depression and suicide; assessment of suicide risk with even small elevations in depressive symptoms; consideration of physical health status and level of hopelessness in assessing suicide risk; research on effective psychotherapies with suicidal older adults; and support of innovative community outreach and intervention programs.

Elderly suicide in India

2019 ◽  
Vol 23 (1) ◽  
pp. 46-53
Author(s):  
Avanish Bhai Patel
Keyword(s):  
Content Analysis ◽  
Cause Of Death ◽  
Design Methodology ◽  
Later Life ◽  
The Elderly ◽  
Indian Society ◽  
Suicidal Tendency ◽  
Content Type ◽  
Factors Affecting ◽  
Elderly Suicide

Purpose The elderly are facing many problems in the phase of life in the contemporary times. The problem of suicide among the elderly is one of them. The purpose of this paper is to focus on the cause of death due to suicide among the elderly in later life. There are two objectives of the present study. The first objective examines the nature and problem of elderly suicide in Indian society. The second objective explores the factors affecting suicidal tendency among the elderly. Design/methodology/approach The data have been collected through two newspapers from January 2013 to April 2013. The content of news items has been analysed through content analysis. Findings The study finds out that the factors such as family problems, chronic diseases, poverty, lack of social status and bankruptcy give rise to feeling of committing suicide among the elderly. Originality/value This is an original paper.

scholarly journals 529 - Suicide in elderly people

2021 ◽  
Vol 33 (S1) ◽  
pp. 75-75
Author(s):  
Afroditi Zartaloudi
Keyword(s):  
Older Adults ◽  
Social Issues ◽  
Physical Dependence ◽  
Community Support ◽  
The Elderly ◽  
Public Health Issue ◽  
Contributing Factors ◽  
Psychological Pain ◽  
Negative Effects ◽  
Elderly Suicide

Background:Suicide is a tragic and distressing phenomenon. The problem of suicide in late life is often neglected by medical professionals, policy makers and the general public. Suicidal behavior in older adults (65 years old and over) is a major public health issue in many countries. Suicide rates are highest among the elderly.Objective:To investigate the main factors associated with suicidal ideation, attempts and completed suicide among the elderly.Method:A literature review was carried out in PubMed and Scopus database.Results:Depression is the most relevant cause found, combined with chronic physical suffering, loss, bereavement, abandonment, loneliness, family conflicts and social exclusion. Differences in gender, ethnicity, the ageing process, social issues and cultural backgrounds are also major contributing factors. The major causal factors for attempted suicide are degenerative and chronic diseases, physical dependence and disability, physical and psychological pain, mental and neurocognitive disturbances and suffering. The issue of suicide prevention in the elderly is also addressed.Conclusions:The negative effects on families, friends and communities following a suicide reinforce the urgency for a better understanding and prevention of suicide. Suicide associated with depression in the elderly can be prevented, provided the person is properly treated. Innovative strategies should improve resilience and positive aging, engage family and community support networks, reach vulnerable older adults, and promote health professionals’ knowledge on elderly suicide.

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