@article{ref1,
title="Physical, mental, and social wellbeing and their association with death by suicide and self-harm in older adults: a community-based cohort study",
journal="International journal of geriatric psychiatry",
year="2020",
author="Erlangsen, Annette and Banks Fafphm, Emily and Joshy, Grace and Calear, Alison L. and Welsh, Jennifer and Batterham, Philip J. and Conwell, Yeates and Salvador-Carulla, Luis",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: to assess associations between physical, mental, and social well-being and suicide and self-harm in a community-based sample of older adults.   METHODS: Using a cohort design, questionnaire data from 102,880 individuals aged 65 years or older living in New South Wales, Australia during 2006-2009 were linked to hospital and cause-of-death databases until 2017. Poisson regressions obtained adjusted Incidence Rate Ratios (IRR).   RESULTS: 109 suicides and 191 deliberate self-harm events occurred. Compared to those reporting excellent/good overall health, older adults reporting fair overall health had higher suicide rates (IRR=2.8, 95% confidence interval: 1.8-4.4). Also, suffering from physical limitations was associated with higher rates of suicide. A fair versus excellent/good memory was associated with higher rates of suicide (IRR=2.0, 1.3-3.3). Male erectile dysfunction was linked to self-harm (IRR=2.8, 1.0-7.7). Suicide rates were elevated with baseline Kessler-10 scores of ≥20 versus <15 (IRR=5.0, 2.9-8.9); the corresponding IRR for deliberate self-harm was 2.9 (1.8-4.8). Elevated rates were observed for both self-reported depression and anxiety. Poor versus excellent/good quality of life was associated with suicide (IRR=4.3, 1.7-10.7) and achieving less than desired to due to emotional problems was linked to self-harm (IRR=1.8 1.3-2.4). Rates were lower in those with ≥5 people to depend on versus one (suicide: IRR=0.5, 0.3-0.9; deliberate self-harm: IRR=0.5, 0.3-0.7).   CONCLUSIONS: older adults experiencing health problems, including those relating to overall health or memory, and those with psychological distress had elevated rates of suicidal behavior. Rates of subsequent self-harm and/or death by suicide were elevated in participants with small social networks. This article is protected by copyright. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0885-6230",
doi="10.1002/gps.5463",
url="http://dx.doi.org/10.1002/gps.5463"
}