Suicide in older adults: early detection and prevention

Suicide in older adults is a growing concern in the field of mental health, not only because of its frequency but also because of the difficulties in detecting it.

Although older adults represent a smaller proportion of the general population, they have one of the highest rates of completed suicide, highlighting the seriousness of the problem.

Statistics and predisposing factors

Figures indicate that between 15 and 35% of older adults may have depressive symptoms, and up to 26% in local studies show clinical signs of depression, often undiagnosed and untreated.

Factors such as grief, loss of social roles after retirement, chronic illness, persistent pain, social isolation, and the perception of being a burden contribute to increased risk. In addition, the stigma surrounding mental disorders in this population reduces the likelihood of seeking help.

Common methods and warning signs

In most cases, older adults who commit suicide have had contact with a medical service in the weeks prior to the act. However, they rarely express their intentions directly.

They often verbalize their distress through nonspecific somatic complaints, such as fatigue, persistent pain, or insomnia. The use of firearms, poisoning, and hanging are common methods in this population, reflecting a high lethality rate in attempts.

Warning signs include loss of interest in pleasurable activities, progressive social isolation, neglect of personal care, repetitive thoughts about death, and sudden changes in mood or behavior.

Protective factors: religion, social networks, and culture

The main protective factors include active religious practice, a sense of purpose provided by cultural norms that value the role of older adults, and the maintenance of functional social networks.

A supportive family, inclusive communities, opportunities for participation, and a sense of purpose significantly reduce the likelihood of suicidal ideation. Integration into older adult groups, recreational or cultural activities, and comprehensive medical care also help preserve mental health.

Initial approach after a suicide attempt in older adults

In the event of a suicide attempt, the response must be immediate, empathetic, and multidisciplinary. It is essential to perform a complete medical evaluation to rule out associated somatic conditions, review medications that may be influencing mood, and explore social, family, and economic factors. The psychiatric assessment should include the identification of depressive disorders, incipient dementia, or the presence of psychotic symptoms.

Based on this, therapeutic strategies are designed that include supportive psychotherapy, family intervention, ongoing support, and, in many cases, pharmacological treatment with antidepressants that have a safe profile for this population.

Follow-up support should focus on emotional rehabilitation and strengthening the older adult's sense of belonging and autonomy. Beyond clinical treatment, suicide prevention at this stage of life requires a comprehensive, empathetic approach that focuses on the dignity of aging.