In Review Suicide and Its Prevention Among Older Adults

dults aged 65 years or over have high rates of suicide worldwide (1). Approximately 1.3 die by suicide in Canada every day (2). Older adults have long had high suicide rates (3–7); however, programmatic study of geriatric suicide is relatively recent. The prevalence of late-life suicides may increase as the baby boom cohort reaches retirement age (8), given this population’s high suicide rates (9,10) and because they are moving into a phase of life in which rates are high. However, baby boomers ’ strength in getting health care needs met (11) may help to stem that tide. Geriatric suicidology is in Can J Psychiatry, Vol 51, No 3, March 2006 143 Objective: To review the research on the epidemiology, risk and resiliency, assessment, treatment, and prevention of late-life suicide. Method: I reviewed mortality statistics. I searched MEDLINE and PsycINFO databases for research on suicide risk and resiliency and for randomized controlled trials with suicidal outcomes. I also reviewed mental health outreach and suicide prevention initiatives. Results: Approximately 12/100 000 individuals aged 65 years or over die by suicide in Canada annually. Suicide is most prevalent among older white men; risk is associated with suicidal ideation or behaviour, mental illness, personality vulnerability, medical illness, losses and poor social supports, functional impairment, and low resiliency. Novel measures to assess late-life suicide features are under development. Few randomized treatment trials exist with at-risk older adults. Conclusions: Research is needed on risk and resiliency and clinical assessment and interventions for at-risk older adults. Collaborative outreach strategies might aid suicide prevention. (Can J Psychiatry 2006;51:143–154) Information on funding and support and author affiliations appears at the end of the article