Published online Jan 19, 2022. doi: 10.5498/wjp.v12.i1.187
Peer-review started: May 4, 2021
First decision: September 5, 2021
Revised: September 17, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: January 19, 2022
Processing time: 258 Days and 8.9 Hours
Suicide is a leading cause of preventable death worldwide, with its peak of maximum incidence in later life. Depression often puts an individual at higher risk for suicidal behaviour. In turn, depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing.
To gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults, and to examine the effects of depression treatment to tackle suicide behaviour in this population.
A systematic review of empirical studies, published from 2000 onwards, was conducted. Suicidal behaviour was addressed considering its varying forms (i.e., wish to die, ideation, attempt, and completed suicide).
Thirty-five papers were selected for review, comprising both clinical and epidemiological studies. Most of studies focused on suicidal ideation (60%). The studies consistently pointed out that the risk was related to depressive episode severity, psychiatric comorbidity (anxiety or substance use disorders), poorer health status, and loss of functionality. Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults. Finally, the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response. Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms.
To sum up, common and age-specific risk factors seem to be involved in suicide development in depressive older adults. A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well.
Core Tip: Suicide constitutes a global health concern. In this regard, suicide is one of the leading ten causes of death in five of the 21 Global Burden of Disease defined regions. Suicide mortality is more prevalent in older adults in comparison to younger adults, due to the cumulated influence of multiple risk factors over time. The role of depression in late-life suicide deserves particular interest due to its elevated prevalence and relationship with functional disability and chronic disease development. Results from this study may contribute to planning intensive assessment protocols in older adults with depression to target suicide, as well as to monitoring suicide behaviour as a key indicator of depression treatment success.