Late-life suicide: a review

Suicide ranked as the ninth leading cause of death in the United States in 1992, with persons over the age of 65 years being at the highest risk. Suicidologists predict a dramatic increase in both the rate and the total number of late-life suicides over the next three decades, highlighting the urgent need for prevention and treatment strategies specifically targeting at-risk older individuals. Comprehensive Medline and PsycLit searches of elderly suicide (and various synonyms thereof) were conducted for English-language publications dating back to 1989, and the bibliographies in these sources were examined for additional publications. An overview of the epidemiology, biology, psychopathology, and frequent medical concomitants of late-life suicide is presented here. Innovative preventive strategies are also briefly summarized. It is concluded that further investigation is needed in several areas: the neurobiology of aging, affective disorders, and suicide; the complex interactions between somatic and psychiatric illnesses; personality traits that may confer vulnerability to suicide in late life; and age-related variations in the prevalence and phenomenology of Axis I psychopathology in suicide victims.