Loss of partner and suicide risks among oldest old: A population-based register study
Abstract
BACKGROUND: while mortality among the oldest old has improved over recent decades, these improvements are not reflected in the suicide mortality of this age group. We do not know the reasons why the suicide mortality is still very high among the oldest old. OBJECTIVE: the aim is to analyse the impact that loss of a partner has on the suicide risks of the oldest old (80+) compared to younger age groups. SUBJECTS: the entire Danish population aged 50 during 1994-1998 (n = 1,978,527). METHODS: we applied survival analysis to calculate the changes in relative risk of suicide after a loss by using individual-level data. RESULTS: the majority of older persons who commit suicide are widowed, although only a relatively small proportion of the oldest old who commit suicide have experienced a recent loss of partner (men: 18%, women: 6%). In absolute terms, the oldest old men experience the highest increase in suicide risk immediately after the loss (15-fold; 95% CI 10.2-23.6) compared to middle-aged men who are still married. Oldest old men seem to suffer more from the loss and need longer time to recover than women. CONCLUSIONS: although a small proportion of oldest old who commit suicide have experienced a recent bereavement, there is a significant increase in the suicide risk during the first year after a bereavement, especially for men. However, the increased risk of suicide in the oldest old men may only in part be explained by the loss of a partner.
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Men aged 80 years and above who had lost their partner during the past year had a 15-fold increase in suicide risk compared to married middle-aged men.
“In a population-based register study of the entire Danish population aged fifty year and older, Erlangsen and colleagues showed that men aged 80 years and above who had lost their partner during the past year had a 15-fold increase in suicide risk compared to married middle-aged men [52].”
From A systematic review of social factors and suicidal behavior in older adulthood (2012) · cites this paper as [52]
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Yang, J., Chen, S., Li, Y., Wang, B., Xin, X., Xia, X., Pan, Z., & Lyu, J. (2018) · Melanoma Research · doi:10.1097/cmr.0000000000000559 · Cited by 14 · see citing works
The impact of the COVID-19 pandemic on suicide mortality in Spain: Differences by sex and age
Martínez‐Alés, G., López‐Cuadrado, T., Morrison, C., Keyes, K. M., & Susser, E. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.02.115 · Cited by 16 · see citing works
“A Danish population-based study found older males' suicide risk immediately following death of the spouse to be 15-fold higher the risk of middle-aged married counterparts (Erlangsen, 2004).”
Suicidal elderly people in clinical and community settings
Leo, D. D., Draper, B., & Krysinska, K. E. (2009) · doi:10.1093/med/9780198570059.003.0095 · Cited by 20 · see citing works
Aportaciones de la medicina forense a la investigación de la conducta suicida
Guija, J. A., Giner, L., Marín, R., Blanco, M., & Parejo-Merino, J. A. (2012) · Revista Española de Medicina Legal · doi:10.1016/j.reml.2012.10.001 · Cited by 12 · see citing works
A concept analysis of suicidal behavior.
Sun, F.-K. (2011) · Public Health Nursing · doi:10.1111/j.1525-1446.2011.00939.x · Cited by 14 · see citing works
Li, Y., Chan, W. C. H., Chen, H., & Ran, M. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1935455 · Cited by 12 · see citing works
“…older adults at increased risk of biological problems (Das, 2013), cognitive impairment (Feng et al., 2014), mortality (Liu et al., 2018), financial burden (Ghesquiere et al., 2016), social withdrawal (Min et al., 2018), loneliness (Yang, 2020), and suicidal ideation (Erlangsen et al., 2004).”
BackgroundWu, J., Li, Y., & Wærn, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19127003 · Cited by 12 · see citing works
“Older people are more likely to experience life events that associate with suicide, such as physical illness and functional disability [14], bereavement, widowhood [15] and social disconnectedness [16].”
BackgroundMapping Psychosocial Risk and Protective Factors in Suicidal Older Persons—A Systematic Review
Holm, A. L., & Severinsson, E. (2015) · Open Journal of Nursing · doi:10.4236/ojn.2015.53030 · Cited by 11 · see citing works
“Physical health problems have been reported as increasing the risk of suicide in elderly persons [8] [35] [52] [53].”
Suicide attempts and deaths in older persons in Ghana: A media surveillance approach
Quarshie, E. N., Asante, K. O., Andoh–Arthur, J., Asare‐Doku, W., & Navelle, P. L. (2018) · Current Psychology · doi:10.1007/s12144-018-9932-5 · Cited by 11 · see citing works
The impact of widowhood on Irish mortality due to suicide and accidents
Corcoran, P. E. (2009) · European Journal of Public Health · doi:10.1093/eurpub/ckp166 · Cited by 11 · see citing works
Lindner, R., Drinkmann, A., Schneider, B., Sperling, U., & Supprian, T. (2022) · Zeitschrift für Gerontologie und Geriatrie · doi:10.1007/s00391-022-02030-w · Cited by 10 · see citing works
Risk of suicide: its occurrence and related variables among bereaved substance users
Masferrer, L., Garre‐Olmo, J., & Caparrós, B. (2015) · Journal of Substance Use · doi:10.3109/14659891.2014.998733 · Cited by 10 · see citing works
“As in other studies, our results showed that being separated or widowed was associated with suicide risk (Erlangsen et al., 2004; Masocco et al., 2010; Wyder et al., 2009).”
ResultIshida, M., Onishi, H., Wada, M., Wada, T., Wada, M., Uchitomi, Y., & Nomura, S. (2010) · Palliative & Supportive Care · doi:10.1017/s1478951509990757 · Cited by 10 · see citing works
“An increased risk of suicide in those who lost a loved one within 1 year has also been reported (Kaprio et al., 1987; Li, 1995; Erlangsen et al., 2004).”
BackgroundUnderstanding the Experiences of Elderly Bereaved Men and the Bond With Their Pets
Thompson, M. C., & Kim, A. B. (2021) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228211004820 · Cited by 9 · see citing works
“The first year of bereavement is the riskiest for men (Erlangsen et al., 2004).”
BackgroundInfluentialAoyama, M., Miyashita, M., Masukawa, K., Morita, T., Kizawa, Y., Tsuneto, S., Shima, Y., & Akechi, T. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.08.019 · Cited by 9 · see citing works
Passive and active suicidal ideation in Swedish 85-year-olds: Time trends 1986–2015
Jonson, M., Sigström, R., Fässberg, M. M., Wetterberg, H., Rydén, L., Sterner, T. R., Hedna, K., Nilsson, U. L., Skoog, I. G., & Wærn, M. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.04.060 · Cited by 9 · see citing works
Does Early Bereavement Counseling Prevent Ill Health and Untimely Death?
Grimby, A., & Johansson, Å. K. (2007) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/1049909107305651 · Cited by 9 · see citing works
Bereavement in the Face of Perinatal Loss: A Hardiness Perspective
Lang, A., & Carr, T. (2012) · Springer eBooks · doi:10.1007/978-1-4614-3917-2_18 · Cited by 8 · see citing works
Lindner, R., & Schneider, B. (2014) · Public Health Forum · doi:10.1016/j.phf.2013.12.024 · Cited by 7 · see citing works
Hedna, K., Sundell, K. A., Hensing, G. K. E., Skoog, I. G., Gustavsson, S., & Wærn, M. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022703 · Cited by 7 · see citing works
“One Danish cohort study found increased risk for suicide among the oldest widowed, especially among men.(34) However, the study included only deaths of partners that occurred during a Table 3 Factors associated with suicide and suicide attempt among new users of antidepressants aged 75 and above (n=185 015)*”
BackgroundHealth professionals need to be able to identify depression in older people
Bèphage, G. (2005) · British Journal of Nursing · doi:10.12968/bjon.2005.14.7.17942 · Cited by 7 · see citing works
Ishida, M., Onishi, H., Wada, M., Tada, Y., Ito, H., Narabayashi, M., Sasaki, Y., Nomura, S., & Uchitomi, Y. (2010) · Japanese Journal of Clinical Oncology · doi:10.1093/jjco/hyq213 · Cited by 7 · see citing works
Ishida, M., Onishi, H., Morita, T., Uchitomi, Y., Shimizu, M., Tsuneto, S., Shima, Y., & Miyashita, M. (2018) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2017.12.493 · Cited by 7 · see citing works
Grande, E., Alicandro, G., Vichi, M., Pompili, M., & Frova, L. (2024) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2024.01.031 · Cited by 7 · see citing works
Sexualité et pathologies du vieillissement chez les hommes et les femmes âgés
Colson, M. (2012) · Gérontologie et société · doi:10.3917/gs.140.0109 · Cited by 7 · see citing works
Missing memories of death: Dissociative amnesia in the bereaved the day after a cancer death
Ishida, M., Onishi, H., Toyama, H., Tsutsumi, C., Endo, C., Tanahashi, I., Takahashi, T., & Uchitomi, Y. (2015) · Palliative & Supportive Care · doi:10.1017/s1478951515000541 · Cited by 5 · see citing works
“It is well known that the bereaved have a variety of distresses: physical (Prigerson et al., 1997; Buckley et al., 2009), psychiatric, psychological (Erlangsen et al., 2004; Cole & Dendukuri, 2003; Zisook & Shear, 2009; Ishida et al., 2012), and behavioral (Prigerson et al., 1997; Grimby &…”
BackgroundThiamine deficiency in the bereaved after cancer-related spousal loss
Onishi, H., Uchida, N., Takahashi, T., Furuya, D., Ebihara, Y., Sato, I., Ito, H., & Ishida, M. (2019) · Palliative & Supportive Care · doi:10.1017/s147895151900018x · Cited by 5 · see citing works
“For example, in psychological terms, there are increases in the incidence of depression (Zisook & Shuchter, 1991) and suicide rate (Erlangsen et al., 2004; Kaprio et al., 1987; Li, 1995), whereas in physical terms, an increase in the mortality rate from cardiovascular disease (Carey et al.”
BackgroundRecommendations for the prevention and management of suicidal behaviour
Ayuso‐Mateos, J. L., Baca‐García, E., Bobes, J., Giner, J., Giner, L., Pérez, V., Sáiz, P. A., & Ruiz, J. S. (2012) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2012.01.002 · Cited by 6 · see citing works
Hedna, K., Fastbom, J., Skoog, I. G., Hensing, G. K. E., & Wærn, M. (2020) · BMC Public Health · doi:10.1186/s12889-020-08892-2 · Cited by 5 · see citing works
Adjustment Disorder Related to Bereavement
Greis, L. M. (2012) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2011.08.018 · Cited by 5 · see citing works
Cognitive Inhibition in Elderly High-lethality Suicide Attempters
Richard‐Devantoy, S., Szántó, K., Butters, M. A., Kalkus, J., & Dombrovski, A. Y. (2015) · European Psychiatry · doi:10.1016/s0924-9338(15)32107-6 · Cited by 5 · see citing works
“Because the suicidal process involves the following: (i) a catastrophic accumulation of stressors (Mathew and Nanoo, 2013), such as widowhood (Erlangsen et al., 2004) and physical illness (Juurlink et al.”
BackgroundLaly, F., Toulouse, O., Duveau, J.-P., Veysseyre, O., & Soussy, A. (2008) · NPG. Neurologie, psychiatrie, gériatrie/NPG · doi:10.1016/j.npg.2008.04.005 · Cited by 4 · see citing works
Wenker, S. L., & Liebzeit, D. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-60912-8.00004-x · Cited by 4 · see citing works
Suicidal older people in clinical and community settings
Leo, D. D., Draper, B., & Krysinska, K. E. (2021) · doi:10.1093/med/9780198834441.003.0071 · Cited by 4 · see citing works
Tay, D. L., Thygesen, L. C., Kozlov, E., & Ornstein, K. A. (2022) · Clinical Epidemiology · doi:10.2147/clep.s372936 · Cited by 4 · see citing works
“Bereavement has been associated with increased use of antidepressants(3) and elevated risks in mortality by natural and non-natural causes in widows(4) and widowers.(5) This risk is especially elevated in the early period of bereavement.”
BackgroundResultRisk factors for suicide in the elderly: What do we know? What do we need to find out?
Wærn, M. (2015) · Suicidologi/Nytt i suicidologi · doi:10.5617/suicidologi.2133 · Cited by 4 · see citing works
Schulte-Wefers, H., & Wolfersdorf, M. (2006) · Journal für Kardiologie (Krause & Pachernegg GmbH) · Cited by 4 · see citing works
Morin, L., Wastesson, J. W., Fors, S., Agahi, N., & Johnell, K. (2020) · medRxiv · doi:10.1101/2020.04.16.20067645 · Cited by 4 · see citing works
- Authors
- Erlangsen, A.
- Affiliations
- Max Planck Society (DE)
- Corresponding author
- Erlangsen, A.
- ORCID
- Erlangsen, A.
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-04-13
- Volume
- 33
- Issue
- 4
- Pages
- 378-383
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- OpenAlex
- W2079116212
- Cited by
- 153
- References
- 23
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 6 · 2021: 10 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 8 · 2016: 9 · 2015: 13 · 2014: 10 · 2013: 10 · 2012: 12
- FWCI
- 4.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Age and Ageing (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Max Planck Institute for Plasma Physics (submittedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- suicide, oldest old, bereavement, loss of a partner, widowhood, suicide risk, gender differences, middle-aged adults
- MeSH terms
- Aged, Aged, 80 and over, Bereavement, Denmark, Female, Humans, Life Change Events, Male, Middle Aged, Suicide, Time Factors, Widowhood
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