Suicidal feelings in the twilight of life: a cross-sectional population-based study of 97-year-olds

OBJECTIVE: To examine the occurrence of past month suicidal feelings in extreme old age. Further, to identify factors associated with such feelings. DESIGN: Cross-sectional population-based study. SETTING: Gothenburg, Sweden. PARTICIPANTS: 269 adults (197 women, 72 men) without dementia born in 1901–1909 who participated in a psychiatric examination. MAIN OUTCOME MEASURES: Death thoughts and suicidal feelings. The latter were rated in accordance with the Paykel questions (life not worth living, death wishes, thoughts of taking own life, seriously considered taking own life, attempted suicide) during the past month. RESULTS: One quarter of the sample (26.7%) reported that they thought about their own death at least once a month. Past month thoughts that life was not worth living were acknowledged by 7.9% of the total sample, death wishes by 10.5% and thoughts of taking life by 3.8%. Few had serious thoughts of taking own life (0.8%) and none had attempted suicide. In all, 11.5% acknowledged some level of suicidal feelings. Most (77.4%) of those who reported such feelings fulfilled criteria for neither major nor minor depression. Neither poor perceived health nor disability (hearing, vision and motor function) was associated with suicidal feelings. Problematic sleep and deficient social contacts were also related to suicidal feelings after adjustment for depression. CONCLUSIONS: Suicidal feelings may occur outside the context of depression and disability in this age group. Results can inform clinicians who care for persons who reach extreme old age.