Suicide in Older Adults Aged 75+ Living in Long-term Care Facilities: A National Register-based Study


Objectives: To investigate the risk of suicide in nursing home residents aged 75 and above and the role of psychiatric and physical conditions.
Methods: A Swedish national register-based cohort study of nursing home residents aged ≥75 years between 1 January 2008 and 31 December 2015, and followed until 31 December 2016 (N=288 305). Fine and Gray regression models were used to analyse associations with suicide.
Results: The study identified 110 suicides (15.8 per 100,000 person-years). The median time spent in nursing home before suicide was 292 days (Interquartile Q1-Q3: 115 – 489) and about one half occurred within a year after moving to nursing home. Adjusted sub-hazard ratio (aSHR) for suicide was decreased in those who were on antidepressants (aSHR 0.64, 95% confidence interval 0.42 to 0.97), even after the exclusion of residents who had healthcare contacts for dementia or were on anti-dementia drugs. The aSHR for suicide was more than two-fold higher in those who were on hypnotics (2.20, 1.46 to 3.31). Suicide risk was particularly elevated in those with an episode of self-harm prior to nursing home residence (15.78, 10.01 to 24.87).
Conclusions: A lower risk of suicide in nursing home residents was found in users of antidepressants, while elevated risk was observed in those on hypnotics, and in those with previous self-harm. Our findings suggest that more can be done to prevent suicide in this setting.

Author Information
Khedidja Hedna, University of Gothenburg, Sweden
Margda Waern, University of Gothenburg, Sweden

Paper Information
Conference: AGen2022
Stream: Built Environment

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Posted by James Alexander Gordon