Correlates of Suicide in the Older Adult Population in Quebec
This study was undertaken to describe the characteristics of adults aged 60 years and over who committed suicide in Quebec in 1998-1999. In this study, 42.6% of the suicide cases presented mental disorders at the time of their death, mainly depression. Sixty-five (65.3%) percent of the suicide cases would have been considered as having a mental health disorder if sub-threshold depression cases were included. Only 27.7% of the cases did not express any idea of death during the 6-month period preceding their suicide. One interesting finding was that 53.5% of the suicide cases consulted a general practitioner or specialist during the 2-week period preceding their death. Our results showed that only 8.1% had a severe level of functional limitations at the time of their death. This result leads us to interpret with caution the conclusion of some studies suggesting that physical frailty is a major causal factor associated with suicide among the elderly.
Available from: Ngui Andre
- "In Canada, it is estimated that 12 per 100,000 persons aged 65 years and over die by suicide each year (Heisel and Duberstein, 2005). The suicide rate among the older adult population in Quebec reached close to 18.5 per 100,000 persons in 1999 (Preville et al., 2005). Despite the fact that suicide prevention has been recognized as a priority in Quebec's Mental Health Action Plan 2005–2010 (MHAP), older adult suicide remains a neglected subject receiving little attention among studies in public health. "
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To determine the influence of individual and neighborhood characteristics associated with suicide in older adults.
This study used two complementary data sources. The first used administrative data from the Quebec coroner’s office and included information on suicide deaths in older adults aged 65 years and over who died by suicide between 2000 and 2005 (n = 903 persons). The second data source, which was used to identify the control group, came from a longitudinal study on seniors’ health that was conducted in Quebec between 2004 and 2005 (n = 2 493 persons). Logistic regression analyses were used to test for associations between suicide and individual and neighborhood level characteristics.
Suicide was associated with male gender, age, the presence of a physical and mental disorder and the use of health services. At the neighborhood level, suicide was associated with a higher population density, concentration of men, lower rates of education and higher rate of unemployment. Gender specific analyses also showed different patterns of associations on suicide risk.
Suicide in older adults is associated with neighborhood and individual characteristics. This suggests that policies targeting only one level of risk factors are less likely to significantly influence suicide among this population.
Available from: Steffi Riedel-Heller
- "Depression is one of the most prevalent psychiatric conditions in later life with potential consequences on disability (Forsell and Winblad, 1999; Papadopoulos et al., 2005), mortality (Preville et al., 2005; Luppa et al., 2007), and institutionalization (Luppa et al., 2010a) with prevalence rates that vary enormously between 4.5% and 37.4% (Luppa et al., 2010b). There are several factors correlating to the occurrence of depressive symptoms in older adults such as poor activities of daily living scores, poor cognitive abilities, chronic physical illness (Liu et al., 1997), and having a poor social support network (Blazer, 2003; Tsai et al., 2005; Djernes, 2006). "
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Social relations have become the focus of much research attention when studying depressive symptoms in older adults. Research indicates that social support and being embedded in a network may reduce the risk for depression. The aim of the review was to analyze the association of social relations and depression in older adults. Methods
Electronic databases were searched systematically for potentially relevant articles published from January 2000 to December 2012. Thirty-seven studies met the inclusion criteria for this review. ResultsFactors of social relations were categorized into 12 domains. Factors regarding the qualitative aspects of social relations seem to be more consistent among studies and therefore provide more explicit results. Thus, social support, quality of relations, and presence of confidants were identified as factors of social relations significantly associated with depression. The quantitative aspects of social relations seem to be more inconsistent. Cultural differences become most obvious in terms of the quantitative aspects of social relations. Conclusion
Despite the inconsistent results and the methodological limitations of the studies, this review identified a number of factors of social relations that are significantly associated with depression. The review indicates that it is needful to investigate social relations in all their complexity and not reduce them to one dimension. Simultaneously, it is important to conduct longitudinal studies because studies with cross-sectional design do not allow us to draw conclusions on causality. Beyond that, cultural differences need to be considered. Copyright (c) 2013 John Wiley & Sons, Ltd.
Available from: David L Streiner
- "First, there is a strong link between depression and suicide; indeed, depression is the major risk factor for attempted and completed suicide (e.g. Préville et al., 2005); and higher suicide rates are seen with other psychiatric disorders, such as schizophrenia (Capasso et al., 2008; Palmer et al., 2005). Moreover, suicide rates increase with age (Conwell and Brent, 1995), although it has been argued that the earlier data may have over-estimated the risk (Bostwick and Pankratz, 2000). "
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ABSTRACT: Many cross-sectional surveys in psychiatric epidemiology report estimates of lifetime prevalence, and the results consistently show a declining trend with age for such disorders as depression and anxiety. In a closed cohort with no mortality, lifetime prevalence should increase or remain constant with age. For mortality to account for declining lifetime prevalence, mortality rates in those with a disorder must exceed those without a disorder by a sufficient extent that more cases would be removed from the prevalence pool than are added by new cases, and this is unlikely to occur across most of the age range. We argue that the decline in lifetime prevalence with age cannot be explained by period or cohort effects or be due to a survivor effect, and are likely due to a variety of other factors, such as study design, forgetting, or reframing. Further, because lifetime prevalence is insensitive to changes in treatment effectiveness or demand for services, it is a parameter that should be dropped from the lexicon of psychiatric epidemiology.
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