Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years

Abstract Background Suicide in old age is a significant contributor to mortality. However, the extent to which life weariness and suicidal thoughts impact on mortality in a long-term perspective is unknown. The aim of this study was to investigate the effect of life weariness and suicidal thoughts o...

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Main Authors: Cecilia Fagerström, Anna-Karin Welmer, Sölve Elmståhl, Hanna Tuvesson
Format: Article
Language:English
Published: BMC 2021-07-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-021-11329-z
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spelling doaj-58f8e68ca92f4f4ebe1d3423d80991792021-07-11T11:16:17ZengBMCBMC Public Health1471-24582021-07-0121111310.1186/s12889-021-11329-zLife weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 yearsCecilia Fagerström0Anna-Karin Welmer1Sölve Elmståhl2Hanna Tuvesson3Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus UniversityDepartment of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm UniversityDivision of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund UniversityDepartment of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus UniversityAbstract Background Suicide in old age is a significant contributor to mortality. However, the extent to which life weariness and suicidal thoughts impact on mortality in a long-term perspective is unknown. The aim of this study was to investigate the effect of life weariness and suicidal thoughts on long-term survival (16 years) in an older Swedish population, controlling for demographic and social network factors and depression. A further aim was to investigate differences in sex and age interactions in relation to mortality among individuals with and without life weariness and suicidal thoughts. Methods A longitudinal cohort study on a national, representative sample of individuals aged 60+ years was conducted within the Swedish National Study of Aging and Care study. The sample included 7213 individuals, who provided information about life weariness and suicidal thoughts through an item derived from the Montgomery-Åsberg Depression Rating Scale. Data were analysed with multivariate Cox proportional hazards models, adjusted for potential confounders. Results At baseline, 12.5% of the participants (14.6% of females and 9.5% of males) reported life weariness and suicidal thoughts. During the 16-year follow-up, a mean survival time was 11.5 years (standard deviation (SD) 5.6), and 3804 individuals died (59.5% females and 40.5% males). Individuals with life weariness and suicidal thoughts had half the survival rate compared with those without such thoughts (24.5% vs. 50.6%), with a mean survival time of 8.4 years (SD 5.7) versus 12.0 years (SD 5.4). The multi-adjusted hazard ratio of mortality for those reporting life weariness and suicidal thoughts was 1.44 (95% confidence interval, 1.30–1.59), with the population attributable risk at 11.1%. In the models, being male or female 80+ years showed the highest multi-adjusted hazard ratio of long-term mortality (ref. female 60–69 years). Conclusions The findings suggested that life weariness and suicidal thoughts were risk factors for long-term mortality, when controlled for sex and age interactions that were found to strongly predict long-term mortality. These findings have practical implications in prevention of mortality, emphasising the importance of screening, identifying, and intercepting older men and women with signs of life weariness and suicidal thoughts. Trial registration Not applicable.https://doi.org/10.1186/s12889-021-11329-zLife wearinessLongitudinal studyOld ageSuicidal thoughts
collection DOAJ
language English
format Article
sources DOAJ
author Cecilia Fagerström
Anna-Karin Welmer
Sölve Elmståhl
Hanna Tuvesson
spellingShingle Cecilia Fagerström
Anna-Karin Welmer
Sölve Elmståhl
Hanna Tuvesson
Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years
BMC Public Health
Life weariness
Longitudinal study
Old age
Suicidal thoughts
author_facet Cecilia Fagerström
Anna-Karin Welmer
Sölve Elmståhl
Hanna Tuvesson
author_sort Cecilia Fagerström
title Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years
title_short Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years
title_full Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years
title_fullStr Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years
title_full_unstemmed Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years
title_sort life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years
publisher BMC
series BMC Public Health
issn 1471-2458
publishDate 2021-07-01
description Abstract Background Suicide in old age is a significant contributor to mortality. However, the extent to which life weariness and suicidal thoughts impact on mortality in a long-term perspective is unknown. The aim of this study was to investigate the effect of life weariness and suicidal thoughts on long-term survival (16 years) in an older Swedish population, controlling for demographic and social network factors and depression. A further aim was to investigate differences in sex and age interactions in relation to mortality among individuals with and without life weariness and suicidal thoughts. Methods A longitudinal cohort study on a national, representative sample of individuals aged 60+ years was conducted within the Swedish National Study of Aging and Care study. The sample included 7213 individuals, who provided information about life weariness and suicidal thoughts through an item derived from the Montgomery-Åsberg Depression Rating Scale. Data were analysed with multivariate Cox proportional hazards models, adjusted for potential confounders. Results At baseline, 12.5% of the participants (14.6% of females and 9.5% of males) reported life weariness and suicidal thoughts. During the 16-year follow-up, a mean survival time was 11.5 years (standard deviation (SD) 5.6), and 3804 individuals died (59.5% females and 40.5% males). Individuals with life weariness and suicidal thoughts had half the survival rate compared with those without such thoughts (24.5% vs. 50.6%), with a mean survival time of 8.4 years (SD 5.7) versus 12.0 years (SD 5.4). The multi-adjusted hazard ratio of mortality for those reporting life weariness and suicidal thoughts was 1.44 (95% confidence interval, 1.30–1.59), with the population attributable risk at 11.1%. In the models, being male or female 80+ years showed the highest multi-adjusted hazard ratio of long-term mortality (ref. female 60–69 years). Conclusions The findings suggested that life weariness and suicidal thoughts were risk factors for long-term mortality, when controlled for sex and age interactions that were found to strongly predict long-term mortality. These findings have practical implications in prevention of mortality, emphasising the importance of screening, identifying, and intercepting older men and women with signs of life weariness and suicidal thoughts. Trial registration Not applicable.
topic Life weariness
Longitudinal study
Old age
Suicidal thoughts
url https://doi.org/10.1186/s12889-021-11329-z
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