TY - JOUR
T1 - Physical, mental, and social wellbeing and their association with death by suicide and self-harm in older adults
T2 - a community-based cohort study
AU - Erlangsen, Annette
AU - Banks, Emily
AU - Joshy, Grace
AU - Calear, Alison L.
AU - Welsh, Jennifer
AU - Batterham, Philip J.
AU - Conwell, Yeates
AU - Salvador-Carulla, Luis
N1 - Funding Information:
This research was completed using data collected through the 45 and Up Study ( www.saxinstitute.org.au ). The 45 and Up Study is managed by the Sax Institute in collaboration with major partner Cancer Council NSW; and partners: the National Heart Foundation of Australia (NSW Division); NSW Ministry of Health; NSW Government Family & Community Services—Ageing, Carers and the Disability Council NSW; and the Australian Red Cross Blood Service. We thank the many thousands of people participating in the 45 and Up Study. Emily Banks, Alison L. Calear and Philip J. Batterham are supported by National Health and Medical Research Council of Australia Fellowships 1136128, 1122544 and 1158707, respectively.
Publisher Copyright:
© 2020 John Wiley & Sons Ltd.
PY - 2021/5
Y1 - 2021/5
N2 - Objective: To assess associations between physical, mental, and social well-being and suicide and self-harm in a community-based sample of older adults. Methods: Using a cohort design, questionnaire data from 102,880 individuals aged 65 years or older living in New South Wales, Australia during 2006–2009 were linked to hospital and cause-of-death databases until 2017. Poisson regressions obtained adjusted incidence rate ratios (IRRs). Results: One hundred nine suicides and 191 deliberate self-harm (DSH) events occurred. Compared to those reporting excellent/good overall health, older adults reporting fair overall health had higher suicide rates (IRR = 2.8, 95% confidence interval: 1.8–4.4). Also, suffering from physical limitations was associated with higher rates of suicide. A fair versus excellent/good memory was associated with higher rates of suicide (IRR = 2.0, 1.3–3.3). Male erectile dysfunction was linked to self-harm (IRR = 2.8, 1.0–7.7). Suicide rates were elevated with baseline Kessler-10 scores of 20–50 versus 10–15 (IRR = 5.0, 2.9–8.9); the corresponding IRR for DSH was 2.9 (1.8–4.8). Elevated rates were observed for both self-reported depression and anxiety. Poor versus excellent/good quality of life was associated with suicide (IRR = 4.3, 1.7–10.7) and achieving less than desired to due to emotional problems was linked to self-harm (IRR = 1.8 1.3–2.4). Rates of suicide ande DSH were lower in those with ≥5 people to depend on versus one (suicide: IRR = 0.5, 0.3–0.9; DSH: IRR = 0.5, 0.3–0.7). Conclusions: Older adults experiencing health problems, including those relating to overall health or memory, and those with psychological distress had elevated rates of suicidal behavior. Rates of subsequent self-harm and/or death by suicide were elevated in participants with small social networks.
AB - Objective: To assess associations between physical, mental, and social well-being and suicide and self-harm in a community-based sample of older adults. Methods: Using a cohort design, questionnaire data from 102,880 individuals aged 65 years or older living in New South Wales, Australia during 2006–2009 were linked to hospital and cause-of-death databases until 2017. Poisson regressions obtained adjusted incidence rate ratios (IRRs). Results: One hundred nine suicides and 191 deliberate self-harm (DSH) events occurred. Compared to those reporting excellent/good overall health, older adults reporting fair overall health had higher suicide rates (IRR = 2.8, 95% confidence interval: 1.8–4.4). Also, suffering from physical limitations was associated with higher rates of suicide. A fair versus excellent/good memory was associated with higher rates of suicide (IRR = 2.0, 1.3–3.3). Male erectile dysfunction was linked to self-harm (IRR = 2.8, 1.0–7.7). Suicide rates were elevated with baseline Kessler-10 scores of 20–50 versus 10–15 (IRR = 5.0, 2.9–8.9); the corresponding IRR for DSH was 2.9 (1.8–4.8). Elevated rates were observed for both self-reported depression and anxiety. Poor versus excellent/good quality of life was associated with suicide (IRR = 4.3, 1.7–10.7) and achieving less than desired to due to emotional problems was linked to self-harm (IRR = 1.8 1.3–2.4). Rates of suicide ande DSH were lower in those with ≥5 people to depend on versus one (suicide: IRR = 0.5, 0.3–0.9; DSH: IRR = 0.5, 0.3–0.7). Conclusions: Older adults experiencing health problems, including those relating to overall health or memory, and those with psychological distress had elevated rates of suicidal behavior. Rates of subsequent self-harm and/or death by suicide were elevated in participants with small social networks.
KW - aged
KW - deliberate self-harm
KW - eyesight
KW - memory
KW - mental disorders
KW - older adults
KW - social network
KW - suicide
KW - suicide attempt
UR - http://www.scopus.com/inward/record.url?scp=85096926712&partnerID=8YFLogxK
U2 - 10.1002/gps.5463
DO - 10.1002/gps.5463
M3 - Article
C2 - 33166417
AN - SCOPUS:85096926712
SN - 0885-6230
VL - 36
SP - 647
EP - 656
JO - International Journal of Geriatric Psychiatry
JF - International Journal of Geriatric Psychiatry
IS - 5
ER -