Suicidal behavior comorbidities in old adults: A systematic review and meta-analysis

The world's population has been aging over the last century. With longevity, many comorbidities need to be better understood, such as suicide and its associations. This review aims to determine the prevalence of comorbidities that may be associated with suicidal behavior in old adults.

We followed the PRISMA 2020 statement. Three databases were searched from inception to October 2024. A maximum limit of ten years was set to include studies that best represent the current prevalence of comorbidities associated with suicide behavior. Meta-analysis compared studies (case-control and cohort) with and without comorbidity with suicidal behavior to evaluate the log odds ratio (logOR).

This review included 41 studies with a total population of 35,361,882. Any comorbidity in older adults had a logOR of 0.803 [95 % CI = 0.35;1.25, p < 0.001]. Depression was the most common comorbidity, with a logOR of 1.16 [95 % CI = 0.51;1.782, p < 0.001]. Older adults with cancer showed a logOR of 0.31 [95 % CI = -0.26;0.84, p = 0.26], indicating no significant difference in suicide rates. The odds of suicide attempts were 2.23 times higher for those with any comorbidity and 3.19 times higher for those with depression.

Depression has emerged as one of the most extensively researched mental health disorders, particularly concerning its association with suicidal behavior. Our findings reaffirm that individuals experiencing depression face a heightened risk of exhibiting suicide attempt. This connection underscores the importance of addressing depressive symptoms as a critical component in suicide prevention efforts.