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A Public Health Concern: Suicide Rates Remain Highest Among Older People

Stria Staff February 23, 2020

The statistics on suicide by older people are clear. What do we know about this public health crisis?

Suicide rates are increasing across all ages groups and is now the tenth leading cause of death in all age groups at nearly 45,000 per year. White 65+ men have the highest completion rates of suicide, most often through the use of a firearm, while large portions of older people also kill themselves by suffocation or overdose. And the rates of suicide increases exponentially with age.

It is a common misconception to think that talking about suicide will increase its occurrence—and the longevity market can help raise awareness of this public health crisis. We have clear statistics that shows this is a real public health issue, so what can we do to change them?

Following are articles and resources that dive into suicide among older people.

Headlines & Insights: Curated excerpts from thought-provoking articles

Unraveling Social Connections Leads Some Seniors to Suicide
Ideastream | Marlene Harris-Taylor

When seniors complete a suicide the response from society is often muted, she said. People don’t seem as outraged when it’s an older person. “It’s almost as if we are thinking, ‘well they’re seniors,’” [Roberta Taliaferro, Director of Counseling at the May Dugan Center] said. “They don’t matter as much. They’re not talked about as much.”…

There are many reasons that seniors consider suicide, but it often boils down to loneliness, isolation, and a sense of uselessness, Taliaferro said.

Many have lost their social connections. They are retired, or have lost their jobs. Their spouses and friends have passed away.

Webinar: Suicide Prevention Among Older Adults
NCOA | Phantane J. Sprowls

…This webinar described the prevalence of and risk factors for suicide among older adults, discussed how suicide is being addressed at the federal level, and shared behavioral health resources. It featured PEARLS, a national evidence-based program for the treatment of depression.

Isolated And Struggling, Many Seniors Are Turning To Suicide
NPR  |  Samantha Balaban, Josh Axelrod, Scott Simon

Across the country, suicide rates have been on the rise, and that rise has struck the nation’s seniors particularly hard. Of the more than 47,000 suicides that took place in 2017, those 65 and up accounted for more than 8,500 of them, according to the Centers for Disease Control and Prevention. Men who are 65 and older face the highest risk of suicide, while adults 85 and older, regardless of gender, are the second most likely age group to die from suicide.

According to the U.S. Census Bureau, there were 47.8 million people over the age of 65 in the U.S. as of 2015. By 2060, that number is projected to reach 98.2 million.

That concerns mental health experts like Dr. Jerry Reed, who manages suicide, violence and injury prevention at the nonprofit Education Development Center.”It’s likely that if we have a problem now, we may very well have a problem in the future if we don’t pay attention,” says Reed.

What’s particularly worrying, say experts like Reed, is that when seniors attempt suicide, they are far more likely to die than those who are younger.

Older Adults at Risk for Opioids and Suicide
Todays Geriatric Medicine | Keith Chan

…while there is a higher risk for suicide in older and younger adults who misuse opioids, the prevalence in older adults is particularly concerning….

“There are different reasons for suicide and substance use, many of which are tied to specific life events and stages in their life course,” [Assistant Professor Keith Chan of the University at Albany School of Social Welfare] says. “When it comes to mental health, older adults are an overlooked and undertreated population. While some older adults live vibrant, healthy lives, others experience declining physical health which can cause chronic pain, and may lead to prescription opioid use, and later, misuse and addiction. Without support and mental health treatment, older adults can become socially isolated, which is a risk factor for suicide.”

In response to the opioid epidemic, he says, public policy must include allocating resources to increase access and use of mental health care, targeting older as well as younger populations to address the risk of suicide.

Suicide in Late Life: Unique Factors and Enduring Treatment Gaps

Suicide Prevention Resource Center | Bradley E. Karlin

Untreated mental illness – especially depression – is a particular risk factor for suicide among older adults. Older adults with depression or other mental health conditions receive treatment at strikingly low rates. A national study examining help-seeking among older Americans found that only 1 in 10 older individuals with severe mental health needs received treatment. Among the barriers to treatment is the fact that  older adults often attribute symptoms of depression or other psychological conditions to aging or to medical conditions. Research in recent years has documented that “perceived need” is an especially important factor in engagement with mental health treatment among older adults. When older adults do recognize their need and seek care, they frequently turn to primary care providers, who often fail to detect symptoms of depression in older patients.

Complicating the detection and treatment of depression among older adults is the fact that depression often manifests differently in late life than in earlier years. Often, depression in older adults is not accompanied by dysphoria (sadness) – a hallmark symptom of depression in younger individuals. Family members and clinicians should look for changes in appetite, sleep patterns, and loss of interest in previously enjoyed activities, as these are often important symptoms of depression in later life

Social risk factors are significant with respect to late life suicide. Among older adults, limited social support and social isolation are more important social risk factors than interpersonal discord and job-related stress, which are more common among younger adults. Promoting family and social support and connectedeness should be considered with older adults who exhibit risk factors for suicide.

Elder Suicide Intervention
Todays Geriatric Medicine | M. Kaleem Arshad, MD, DFAPA

Depression or Dementia?
While depression can be common among the elderly, it can be difficult for health care professionals to accurately diagnose mental illness in older patients because dementia can cause the same symptoms.

For example, some symptoms common to both depression and dementia include apathy, loss of interest in activities and hobbies, social withdrawal, isolation, difficulty concentrating, and impaired thinking.

Given the fact that more than 5 million Americans are living with Alzheimer’s disease, it is important to carefully screen patients exhibiting these symptoms to help determine the correct plan of care.

This story was created in partnership with students from the Department of Gerontology at Virginia Commonwealth University. Thanks to Tabbitha Bruck for contributing research for this piece on suicide among older people.

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