Suicide in older people: mode of death, demographic factors, and medical contact before death

OBJECTIVE: To determine the demographic characteristics, mode of death, and nature and timing of medical contacts in the year before death in a sample of suicides in older people. DESIGN: Descriptive study of a case series of 195 suicides in older people. SETTING: Four counties and one large urban area in central England, UK. SUBJECTS: Individuals 60 years old and over at time of death, who had died between 1 January 1995 and 1 May 1998, and whose deaths has received a coroner's verdict of suicide, or an open or accidental verdict where the circumstances of death indicated probable suicide. MAIN OUTCOME MEASUREMENTS: Demographic details and information on mode of death and medical contact prior to death derived from coroners' inquest notes, General Practitioners' (GP) case-notes and psychiatric records. MAIN RESULTS: 67.7% were male. A higher proportion of men than women were single or divorced. The commonest methods of suicide were hanging in men and drug overdose in women, 49.8% had seen their GP in the month before death, although over half these last consultations were for physical complaints. Only 15.4% were under psychiatric care at the time of death. CONCLUSIONS: Older men are at higher risk of suicide than women. Given the high proportion of drug overdoses in the sample, effective strategies to prevent suicide in older people might include improving the prescribing of analgesics and antidepressants. Although older people at risk of suicide often consult their GP shortly before death, GPs may have difficulty identifying those at risk because of the high proportion of physical complaints.