SUICIDE IN ELDERLY

Volume 3 Issue 10 October, 2013

There is a global trend towards increased suicide in late life. Developed countries show a second peak of increased
suicide rate in the elderly (above 60 years). In 2011, around 8% of suicide victims in India were of age 60 years or more.
The suicide rates in elderly in India are less compared to west but the trend in increasing in India too. Till now, the low
prevalence of suicide among the elderly in India could be because the aged are well-integrated and respected in the
family; children take responsibility for their care; and life expectancy in the elderly is lower in India than elsewhere. With
rapid urbanization, disintegrating family structures and increasing life expectancy, these trends are likely to change and
elderly shall become more vulnerable to isolation.

Major reason behind suicide in elderly in India is physical illness (37.8%) followed by family problems. The ratio of
completed suicide to attempted suicide in India is about 1:7 in the elderly, which is double the ratio of 1:15 in lower age groups. This could be due to poorer ability of the elderly to recover from the bodily insult of a suicide attempt.

In the elderly, common risk factors for suicide include: the recent death of a loved one, physical illness, uncontrollable
pain or the fear of a prolonged illness, perceived poor health, social isolation and loneliness and major changes in social roles (e.g. retirement). Warning signs of suicidal intent in elderly include statements about death and suicide, reading material about death and suicide, stockpiling medications, rush to complete or revise a will, increased alcohol or prescription drug use, sudden interest in firearms ( in western population) and overt suicide threats.

Important steps need to be taken in direction of prevention of suicide in elderly. It is believed that 40-70% of victims
contact their general physicians in 30 days preceding suicide. Therefore, sensitization of general physicians in
recognizing suicidal risk and treatment of depression in elderly could be of significant help. The psychiatrists also need to increase their sensitivity towards this issue and must handle every such case reaching their doors with utmost care.
Community based outreach services (currently non-existent in India) can go a long way in decreasing the risk.

Although suicide and its prevention remain a significant public health concern, suicide in the elderly still receives little
focus in terms of specific preventive strategies or research. The situation is compounded by the failed recognition and
failed treatment of even those elderly who come into contact with services. Fundamental to this process is the need to
educate health professionals and society in general that the act of suicide in late life is rarely a rational act.