ABSTRACT Background Epidemiological research on self‐harm in older adults (aged 65+ years) remains scarce despite its growing public health significance amid global ageing. Aims This study aimed to analyse the global burden, risk factors and projections of self‐harm mortality in adults aged 65+ years from 1990 to 2050. Methods Utilising data from the Global Burden of Disease Study 2021, this research examined the spatiotemporal patterns of self‐harm mortality and years of life lost by age, gender and socio‐demographic index (SDI) in adults aged 65+ across 204 countries and territories (grouped into 21 regions) from 1990 to 2021. It also explored the changes during the coronavirus disease 2019 pandemic, identified key risk factors and projected the future burden of self‐harm mortality through 2050. Results Global self‐harm deaths among older adults increased from 116 642 in 1990 to 167 920 in 2021, a rise of 43.96%. However, the age‐standardised mortality rate (ASMR) decreased by 39.56%, from 36.83 to 22.26 per 100 000. In 2021, central sub‐Saharan Africa had the highest ASMR at 61.35 per 100 000, while North Africa and the Middle East recorded the lowest at 4.88 per 100 000. Male ASMR was 2.5 times as high as that of females (33.61 vs. 13.58 per 100 000), and adults aged 85 years and older were at particularly elevated risk. High alcohol use was identified as a major risk factor, especially for males. A U‐shaped relationship between ASMR and the SDI was observed, with the lowest point at an SDI of approximately 0.70. Projections indicate a further 46.05% decline in ASMR to 12.01 per 100 000 by 2050. Conclusions These results highlight complex global trends in self‐harm mortality and associated risk factors among older adults, emphasising the urgent need for sex‐, age‐, and region‐specific interventions, enhanced social support and systematic risk monitoring to inform age‐friendly self‐harm prevention policies, and sustainable development support goals.
Xu et al. (Wed,) studied this question.