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Suicidal ideation in the elderly: Psychosocial risk factors and precipitants

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    1 15 Michigan St NE, 736-B, Grand Rapids, MI 49503, United States of America.
    Lindsey Ouellette
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    1 15 Michigan St NE, 736-B, Grand Rapids, MI 49503, United States of America.
    Affiliations
    Michigan State University College of Human Medicine, Department of Emergency Medicine, Grand Rapids, MI, United States
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
    Allison Cook
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
    Affiliations
    Michigan State University College of Human Medicine, Department of Emergency Medicine, Grand Rapids, MI, United States
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
    Keegan Michel
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
    Affiliations
    Michigan State University College of Human Medicine, Department of Emergency Medicine, Grand Rapids, MI, United States
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
    Leah Harvey
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
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    Michigan State University College of Human Medicine, Department of Emergency Medicine, Grand Rapids, MI, United States
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
    Chad Sutliffe
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
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    Allied Health Sciences Department, Grand Valley State University, Grand Rapids, MI, United States
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
    Todd Chassee
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    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
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    Spectrum Health - Michigan State University Emergency Medicine Residency Program, Grand Rapids, MI, United States
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  • Jeffrey Jones
    Correspondence
    Corresponding author at: 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States.
    Affiliations
    Michigan State University College of Human Medicine, Department of Emergency Medicine, Grand Rapids, MI, United States

    Spectrum Health - Michigan State University Emergency Medicine Residency Program, Grand Rapids, MI, United States
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  • Author Footnotes
    1 15 Michigan St NE, 736-B, Grand Rapids, MI 49503, United States of America.
    2 15 Michigan St NE Suite 701, Grand Rapids, MI 49503, United States of America.
Published:March 05, 2019DOI:https://doi.org/10.1016/j.ajem.2019.01.058
      Suicide is a major health problem, ranking as the 10th leading cause of death in the United States and accounting for approximately 47,173 deaths in 2017 [

      American Foundation for Suicide Prevention. Suicide statistics, https://afsp.org/about-suicide/suicide-statistics/ [[accessed 4 December 2018]].

      ]. In Michigan, the rate of death by suicide is approximately 13.27 per 100,000 population, which is comparable to the national rate as of 2016 [

      American Foundation for Suicide Prevention. Suicide statistics state fact sheets: Michigan, https://afsp.org/about-suicide/state-fact-sheets/#Michigan [[accessed 4 December 2018]].

      ]. Older adults are disproportionately impacted by suicide. Nationally, older adults make up approximately 12.5% of the population, however they account for 15.9% of suicides [

      Illinois Department of Public Health. Injury prevention: suicide and older adults, http://www.idph.state.il.us/about/chronic/Suicide-Older_Adults.pdf [accessed 18 December 2018].

      ]. In Michigan, data from 2007 to 2009 demonstrated that the suicide rate was highest among males aged 65 years and older, and that the overall rate was four times higher for males than females [

      Michigan Department of Community Health. Suicide in Michigan: a hidden health issue, https://www.michigan.gov/documents/mdch/suicide_fact_sheet_region_8_final_390537_7.pdf, [accessed 18 December 2018].

      ]. Many suicide attempts, however, go unreported or untreated. Suicide and self-harm in the elderly generally receive less attention in the medical literature than suicide in young adults. Few investigations have been performed to determine prevalence rates, method of suicide or attempted suicide, and the problems faced by emergency clinicians and paramedics when treating these patients. It has been previously noted that factors such as psychiatric illness, social connectedness between the elderly and their family, friends and community, physical illness, and functional capacity may all have an impact on an individual's risk for suicide or attempts [
      • Carter M.W.
      • Reymann M.R.
      ED use by older adults attempting suicide.
      ]. The purpose of this study was to describe patterns of older adult patient visits to emergency department (ED) for self-harm and suicidal ideation with specific attention to psychosocial risk factors and precipitants.

      Keywords

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      References

      1. American Foundation for Suicide Prevention. Suicide statistics, https://afsp.org/about-suicide/suicide-statistics/ [[accessed 4 December 2018]].

      2. American Foundation for Suicide Prevention. Suicide statistics state fact sheets: Michigan, https://afsp.org/about-suicide/state-fact-sheets/#Michigan [[accessed 4 December 2018]].

      3. Illinois Department of Public Health. Injury prevention: suicide and older adults, http://www.idph.state.il.us/about/chronic/Suicide-Older_Adults.pdf [accessed 18 December 2018].

      4. Michigan Department of Community Health. Suicide in Michigan: a hidden health issue, https://www.michigan.gov/documents/mdch/suicide_fact_sheet_region_8_final_390537_7.pdf, [accessed 18 December 2018].

        • Carter M.W.
        • Reymann M.R.
        ED use by older adults attempting suicide.
        Am J Emerg Med. 2014; 32: 535-540
        • Conwell Y.
        • Van Orden K.
        • Caine E.D.
        Suicide in older adults.
        Psychiatr Clin N Am. 2011; 34: 451-468