Characteristics and Comorbid Symptoms of Older Adults Reporting Death Ideation

Objective To determine whether death ideation in late life is associated with markers of elevated risk for suicide, or reflects normal psychological processes in later life. Design/Setting Population-based cross-sectional study in Gothenburg, Sweden. Participants The sample consists of 345 men and w...

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Bibliographic Details
Published in:The American journal of geriatric psychiatry 2013-08, Vol.21 (8), p.803-810
Main Authors: Van Orden, Kimberly A., Ph.D, Simning, Adam, Ph.D, Conwell, Yeates, M.D, Skoog, Ingmar, M.D., Ph.D, Waern, Margda, M.D., Ph.D
Format: Article
Language:English
Subjects:
Aged, 80 and over
Annan medicin och hälsovetenskap
Anxiety
Anxiety - psychology
Comorbidity
Cross-Sectional Studies
Death
depression
Depression - psychology
Female
Humans
Internal Medicine
Male
Other Medical Sciences
risk assessment suicide
Risk Factors
Suicidal Ideation
Sweden
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Summary:Objective To determine whether death ideation in late life is associated with markers of elevated risk for suicide, or reflects normal psychological processes in later life. Design/Setting Population-based cross-sectional study in Gothenburg, Sweden. Participants The sample consists of 345 men and women of age 85 years (born 1901–1902) and living in Gothenburg, Sweden. Main Outcome Measures The Paykel Scale measured the most severe level of suicidality over an individual's lifetime. Other key measures were severity of depression and anxiety and frequency of death/suicidal ideation over the previous month. Results Latent class analysis revealed distinct groups of older adults who reported recent death ideation. Recent death ideation did not occur apart from other risk factors for suicide; instead individuals reporting recent death ideation also reported either 1) recent high levels of depression and anxiety, or 2) more distant histories of serious suicidal ideation (indicative of worst point severity of suicidal ideation)—both of which elevate risk for eventual suicide. Conclusions Our results indicate a heterogeneous presentation of older adults who report death ideation, with some presenting with acute distress and suicidal thoughts, and others presenting with low distress but histories of serious suicidal ideation. The presence of death ideation is associated with markers of increased risk for suicide, including “worst point” active suicidal ideation.
ISSN:1064-7481
1545-7214
DOI:10.1016/j.jagp.2013.01.015