Depression

Depression and suicide are two causes of death that are increasing in prevalence for all age groups. They are also on the rise in a specific age group, that of older adults. The theory behind this finding that older adults are becoming more and more depressed and committing suicide at a greater rate than ever before is due to their failing physical and mental health. The purpose of this paper is to expand upon and prove this theory by gathering statistics about suicide in older adults, and by obtaining the information of scholarly sources by summarizing their views as it relates to the above mentioned theory.

Official suicide statistics identify older adults as a high-risk group (Mireault & Deman, 1996). In 1992, it was reported that older adults comprised about 13% of the U.S. population, yet accounted for 20% of its suicides; in contrast, young people, ages 15-24, comprised about 14% of the population and accounted for 15% of the suicides (Miller, Segal, & Coolidge, 2001). Among older persons, there are between two to four suicide attempts for every completed attempt (Miller, Segal, & Coolidge, 2001). However, the suicide completion rate of older adults is 50% higher than the population as a whole. This is because older adults who attempt suicide die from the attempt more often than any other age group. Not only do elders kill themselves at a greater rate than any other group in society, but they tend to be more determined and purposeful (Weaver & Koenig, 2001).

Studies of Depression and Suicide in Older Adults

Depression in Older Adults

A study was conducted examining the relationships between disease severity, functional impairment, and depression among a sample of older adults with age-related macular degeneration. It showed that the relationship between visual acuity and physical function was moderated by depressive symptoms (Casten, Rovner, & Edmonds, 2002). It appears that when faced with vision loss, depressed persons tend to generalize their disability to activities that are not necessarily vision dependent. They seem to adopt the attitude of not being able to see leads to not being able to do. This attitude is in line with the cognitive theory of depression in which depressed persons engage in faulty information processing (Casten, Rovner, & Edmonds, 2002).

Suicide in Older Adults

A study about older adult suicide was conducted by Zweig and Hinrichsen (1993). This study included 150 community-dwelling adults, age 60 and over, who were admitted to a psychiatric inpatient service. Each member met the criteria for major depressive disorder. The patients and family members were interviewed six and twelve months after the patients were admitted to the hospital. Eleven of the 126 older patients attempted suicide within the year following inpatient admission for major depressive disorder, however none of the attempts resulted in death (Zweig & Hinrichsen, 1993). Of the patients who attempted suicide, 73% did so during the six to twelve month period following hospitalization (Zweig & Hinrichsen, 1993). The study then went on to explore the differences between those who attempted suicide and those who did not. Individuals who attempted suicide occupied, on average, a higher social class position (Zweig & Hinrichsen, 1993). They were also less likely to experience remission, and were more likely to relapse if they did experience remission. The study also found that interpersonal factors were associated with suicidal behavior in the patients.

Suicide Notes From Older Adults

Suicide notes are traditionally considered markers of the severity of the suicide attempt and often provide valuable insights into the thinking of suicide victims before the final act (Salib, Cawley, & Healy, 2002). A study was done examining the phenomenon of suicide notes in 125 older people who died unexpectedly and in whom a suicide verdict was returned by the Coroner over a period of 10 years. The goal of the study was to see whether there was a difference between suicide note-leavers and non-note-leavers in older victims of suicide (Salib, Cawley, & Healy, 2002).

Data was collected from the files of a Coroner's office in a particular town. All of the data was from deceased people aged 60 and above whose deaths were ruled as suicides. Deceased older adults who left suicide notes were compared to those who did not over a period of ten years. During the 10-year review period, 125 older people died as a result of suicide. In 54 cases (43%), a suicide note was found in the coroner's records for 31 (57%) males and 23 (47%) females (Salib, Cawley, & Healy, 2002). For note-leavers, the average age was 71, and for those who did not leave notes, the average age was 74.

Older suicide note-leavers were less likely to be known to psychiatric services, did not have recent psychiatric treatment, and were less likely to have used violent methods, and did not previously attempt suicide. Suicide notes accompanied most of the cases of suicide that resulted from an overdose, using plastic bags, electrocution, or using car exhausts. Most cases of drowning did not leave suicide notes, none of the men who killed themselves by drowning or falling from a height left suicide notes, nor did the deceased who fatally wounded themselves or jumped in front of a train. More women than men who chose to die by hanging left notes (Salib, Cawley, & Healy, 2002). Those who died by hanging, jumping from heights, immolation, or wounding appeared equally likely to leave or not leave a note (Salib, Cawley, & Healy, 2002). Also, older people who killed themselves at weekends were less likely to leave a suicide note. older people who were in their 70s referred primarily to financial problems, social isolation, fear, sadness, loneliness, and physical illness (Salib, Cawley, & Healy, 2002).

This study found that many older people may be isolated and have no one to communicate with, while others may no longer have the ability to express themselves. Failure to identify consistent parameters that could differentiate between note-leavers and non-note-leavers should not be taken to mean that absence of a suicide note must not be considered an indicator of a less serious attempt (Salib, Cawley, & Healy, 2002).

Reasons for Depression and Suicide in Older Adults

Depression in Older Adults

Depression is the most common diagnosis in older adults who have attempted suicide (Zweig & Hinrichsen, 1993). Depression frequently accompanies a chronic disease, particularly when the disease impairs function (Casten, Rovner, &