Assessment of suicidal ideation and behavior in community-dwelling older adults: a systematic review

This systematic review aims to provide a comprehensive overview of the available instruments to detect suicidal ideation and behavior in community-dwelling older adults. We further aim to evaluate the instruments' psychometric properties, diagnostic accuracy, and practical utility. A systematic review of PubMed, PsycINFO, Sociological Abstracts, and Web of Science databases was carried out. Risk of bias was evaluated with the COSMIN risk of bias checklist or the QUADAS 2 tool. 22 studies detailing 22 instruments were found. Instruments either assessed suicidality directly or indirectly, through the assessment of depression or known risk factors. Psychometric evaluation showed that the validity was better in the original instruments rather than shortened instruments. Evidence for reliability was not always sufficient. All instruments had good diagnostic accuracy. Most instruments were suitable for primary care settings, but their use is context dependent. A variety of instruments are used. Additional research is required for validation and practical use. Valid instruments assessing suicidality, depression, or risk factors can be used to detect suicide risk in community-dwelling older adults.