Suicidal feelings in a population sample of nondemented 85-year-olds

OBJECTIVE: The authors studied the 1-month frequency of suicidal feelings among very old people. METHOD: A population sample (N = 345) of nondemented 85-year-olds in Gothenburg, Sweden, were examined by a psychiatrist. Suicidal feelings were rated by the system of Paykel et al. Mental disorders were diagnosed according to DSM-III-R. RESULTS: Of the mentally healthy subjects (N = 225), 4.0% had thought during the last month that life was not worth living, 4.0% had had death wishes, and 0.9% had thought of taking their own lives. None had seriously considered suicide. The figures were higher among subjects with mental disorders (N = 120); 29.2% had thought that life was not worth living, 27.5% had had death wishes, 9.2% had thought about taking their lives, and 1.7% had seriously considered suicide. Among the subjects with mental disorders, including depression, suicidal feelings were associated with greater use of anxiolytics but not of antidepressants. Women who felt that life was not worth living had a higher 3-year mortality rate than did women without these feelings (43.2% versus 14.2%). This finding was independent of concomitant physical and mental disorders. CONCLUSIONS: Mild suicidal feelings are common in elderly subjects with metal disorders but infrequent in the mentally healthy. The substantially higher mortality rate in women who felt that life was not worth living, compared to women who did not, suggests these feelings must be taken seriously. Because of the high suicide rate in the elderly, there is a need for better diagnosis and treatment of mental disorders in this age group.