January 1, 1999

Suicides among the elderly aged 65 and over are rising at an alarming rate. Between 1980 and 1992, the number of suicides in this age group increased 36 percent, from 4,537 to 6,160. Suicide rates among men in this age group rose 10 percent in the same period, accounting for 81 percent of suicides, according to a recent report from the Centers for Disease Control and Prevention (CDC).

The most dramatic increase in suicide rates in that period was for men and women in the 80 to 84 age group (35 percent).

The elderly have disproportionately high rates of suicide compared with other age groups. People aged 65 and older made up 13 percent of the population in 1992 but accounted for almost 20 percent of all suicides, according to the CDC.

Suicide researcher Yeates Conwell, M.D., told Psychiatric News that compared with younger men, older men are four times more likely to die by suicide, are less likely to warn of their intent to commit suicide, and are more determined to carry out their destructive plans.

Conwell is an associate professor of psychiatry and director of the laboratory of suicide studies at the University of Rochester School of Medicine.

"The tragedy is that in 90 percent of the suicides, the individuals had diagnosable psychiatric illnesses. Mood disorders especially major depression and comorbid substance abuse were most common in the elderly," said Conwell.

Additional risk factors for the elderly are social isolation and greater use of highly lethal methods, according to the CDC. Firearms were the most common method of suicide for both men (74 percent) and women (31 percent) in persons aged 65 and over. The rate of firearm-related suicide increased by 24 percent between 1980 and 1992.

Conwell noted that the elderly also tend to have higher rates of physical illnesses. "The irony is that depression is largely undetected in the elderly and that most who committed suicide had visited a health care provider within the last month."

He recommended that suicide-prevention strategies target depression in the elderly, especially elderly men. "Because the majority of elderly people don't think in psychological terms, the challenge for primary care physicians is to take the time to make the person who may be anxious feel safe and tease out psychiatric symptoms from often complicated medical problems."

Resources on treating depression in the elderly can be found at the Web site of the American Association for Geriatric Psychiatry at

The CDC report "Suicide Among Older Persons-United States, 1980-1992," is posted at the CDC's Web site at www.cdc.gov/epo/mmwr/preview/mmwrhtml/00039937.htm.