Objective: To provide primary care practitioners with the knowledge required to identify and address older adult suicide risk in their practice.
Methods: Review of the literature and good clinical practices.
Results: Primary care practitioners play an important role in older adult suicide prevention and must have knowledge about older adult suicide risk, including risk factors and warning signs in this age-group. Practitioners also must appropriately screen for and manage suicide risk. Older adults, particularly older men, are at high risk for suicide, though they may be less likely to report suicide ideation. Additionally, older adults frequently see primary care practitioners within a month prior to death by suicide. A number of older adult–specific risk factors are reviewed, and appropriate screening and intervention for the primary care setting are discussed.
Conclusion: Primary care practitioners are uniquely qualified to address a broad range of potential risk factors and should be prepared to identify risk factors and warning signs for older adult suicide, ask appropriate questions to screen for suicide risk, and intervene to prevent suicide.
Primary care practitioners play an important role in older adult suicide prevention and have a responsibility to identify and address suicide risk among older adults. To do so, practitioners must understand the problem of older adult suicide, recognize risk factors for suicide in older adults, screen for suicide risk, and appropriately assess and manage suicide risk. Primary care practitioners may face challenges in completing these tasks; the goal of this article is to assist practitioners in addressing these challenges.
Suicide in Older Adults
Suicide among older adults is a significant public health problem; an older adult dies by suicide every 68 minutes in the United States, resulting in 7693 deaths by suicide among adults ages 65 and older in 2014 [1]. This translates to a rate of 16.6 deaths by suicide per 100,000 older adults in the population, a substantially higher rate than among younger adults (ie, 11.6 per 100,000 among adolescents and young adults aged 15 to 24) [2]. In fact, the group with the highest rates of suicide in the United States are older men; men over the age of 84 have a suicide rate of 49.9 per 100,000. Among older men, the rate of suicide steadily increases beginning at the age of 65 ( Figure 1 ) [2].
The United States has recently seen increases in suicide rates across the lifespan; from 1999 to 2014, the suicide rate rose by 24% across all ages [3]. Among both men and women aged 65 to 74, the suicide rate increased in this time period [3]. The high suicide rate among older adults is particularly important to address given the increasing numbers of older adults in the United States. By 2050, the older adult population in the United States is expected to reach 88.5 million, more than double the older adult population in 2010 [4]. Additionally, the generation that is currently aging into older adulthood has historically had higher rates of suicide across their lifespan [5]. Given that suicide rates also increase in older adulthood for men, the coming decades may evidence even higher rates of suicide among older adults than previously and it is critical that older adult suicide prevention becomes a public health priority.
