CoChat
Sign Up
Cited by 342Suicide and Self-Harm StudiesAging, Health, and DisabilityHealth disparities and outcomes

A systematic review of social factors and suicidal behavior in older adulthood

Open access
Fässberg, Madeleine Mellqvist, Orden, Kimberly A. van, Duberstein, Paul, Erlangsen, Annette, Lapierre, Sylvie, Bodner, Ehud, Canetto, Silvia Sara, Leo, Diego De +2 more·2012·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph9030722PMC PMC3367273
Open this paper in CoChat — free accountOpen PDF

Abstract

Suicide in later life is a global public health problem. The aim of this review was to conduct a systematic analysis of studies with comparison groups that examined the associations between social factors and suicidal behavior (including ideation, non-fatal suicidal behavior, or deaths) among individuals aged 65 and older. Our search identified only 16 articles (across 14 independent samples) that met inclusion criteria. The limited number of studies points to the need for further research. Included studies were conducted in Canada (n = 2), Germany (n = 1), Hong Kong (n = 1), Japan (n = 1), Singapore (n = 1), Sweden (n = 2), Taiwan (n = 1), the U.K. (n = 2), and the U.S. (n = 3). The majority of the social factors examined in this review can be conceptualized as indices of positive social connectedness—the degree of positive involvement with family, friends, and social groups. Findings indicated that at least in industrialized countries, limited social connectedness is associated with suicidal ideation, non-fatal suicidal behavior, and suicide in later life. Primary prevention programs designed to enhance social connections as well as a sense of community could potentially decrease suicide risk, especially among men.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review found that limited social connectedness is associated with suicidal ideation, non-fatal suicidal behavior, and suicide in later life, at least in industrialized countries. Only 16 articles across 14 independent samples met inclusion criteria, and the most-studied factors—marital status, living arrangement, and frequency of social contact—showed inconsistent results.

Key findings

  • The review identified 16 publications from 14 independent studies of adults aged 65 and older, conducted in Canada (n = 2), Germany (n = 1), Hong Kong (n = 1), Japan (n = 1), Singapore (n = 1), Sweden (n = 2), Taiwan (n = 1), the U.K. (n = 2), and the U.S. (n = 3).
  • Box-score summaries showed consistent evidence for low social integration (4 of 5 studies), loneliness (2 of 2), relationship discord (3 of 3), and religion (3 of 4), but inconsistent evidence for marital status (4 of 11 with some association; 7 of 11 no association) and living arrangement (3 of 11 with some association; 1 mixed; 7 no association).
  • Specific associations included loneliness and suicide attempt (OR = 2.8, 95% CI = 1.3–6.1), loneliness and suicide in men (OR = 6.8, 95% CI = 2.6–18.0) and women (OR = 8.4, 95% CI = 3.2–22.3), interpersonal conflict and suicide in men (OR = 10.0, 95% CI = 1.7–59.8) and women (OR = 9.2, 95% CI = 1.97–44.8), and family discord and suicide in Hong Kong (OR = 41.0, 95% CI = 5.4–313.6).
  • Protective associations included attending religious services at least monthly and suicide (OR = 0.29, 95% CI = 0.09–0.83), friend confidant and suicide (OR = 0.41, 95% CI = 0.22–0.74), and living with children and suicide attempt (OR = 0.2, 95% CI = 0.03–0.9) and suicide (OR = 0.2, 95% CI = 0.04–0.6).

Methods

  • Cochrane Collaboration guidelines were used for this systematic review; eligible studies were case-comparison studies focused on persons aged 65 and above, published in peer-reviewed journals, and examining both social factors and suicide or related phenomena (death wishes, suicide ideation, deliberate self harm/non-fatal suicidal behavior).
  • Searches were performed in ERIC, Scopus, SUMMON, PubMed, and PsycINFO during August–September 2011 using terms: suicid* OR death wishes OR deliberate self harm; no social-factor search terms were applied, and all publication years were considered.
  • The combined searches yielded 23,299 references; 16 publications based on 14 studies met inclusion criteria, and associations confirmed in multivariate analyses were preferred over univariate.

Limitations

  • The paper states that it included a broadly defined range of suicidal behaviors (death wishes, suicide ideation, non-fatal and fatal suicidal behavior) and that it cannot be assumed these phenomena share the same risk factors.
  • The paper states that meta-analysis was not feasible given the limited number of publications and the broad spectrum of recruitment procedures, variables, and instruments; it also states that sex-specific data for older adults were lacking except in the Rubenowitz study, which is problematic given the sex differential in older-adult suicide rates.
  • Evident from the text: only 16 articles met inclusion criteria, most studies were from industrialized countries, and the review notes heterogeneity across studies and the need for more research in different settings and oldest-old populations.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3390/ijerph9030722

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 165 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Seven studies (with eight publications) focused on death wishes/suicide ideation.

    “Seven studies (with eight publications) focused on death wishes/suicide ideation [27,28,29,30,31,32,33,34].”
    Quote in the paperNot a substantial claim0 of 8 sources checked
    • cites [27] Barnow, 2004, The relation between suicidal feelings and mental disorders in the elderly: Results from the Berlin Aging Study (BASE)., Psychol. Med. source

      Not checked in the free run.

    • cites [28] Bartels, 2002, Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [29] Fortin, 2001, Suicidal ideation and self-determination in institutionalized elderly, Crisis source

      Not checked in the free run.

    • cites [30] Lapierre, 2012, Daily hassles, physical illness, and sleep problems in older adults with wishes to die, Int. Psychogeriatr. source

      Not checked in the free run.

    • cites [31] Raue, 2007, Suicidal ideation among elderly homecare patients, Int. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [32] Rowe, 2006, Social support and suicidal ideation in older adults using home healthcare services, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [33] Tan, 2008, Severity of depression and suicidal ideations among elderly people in Singapore, Int. Psychogeriatr. source

      Not checked in the free run.

    • cites [34] Yen, 2005, Suicidal ideation and associated factors among community-dwelling elders in Taiwan, Psychiatry Clin. Neurosci. source

      Not checked in the free run.

  • Findingcitation

    No association between marital status and suicide was found in a prospective U.S. population-based study.

    “Turvey presented data from a prospective U.S. population-based study showing no association between marital status and suicide [41].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [41] Turvey, 2002, Risk factors for late-life suicide: A prospective community-based study, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • Findingcitation

    Marital status did not differ in persons who reported death wishes/suicidal thoughts/non-fatal suicidal behavior compared to those without death wishes in Germany.

    “Marital status did not differ in persons who reported death wishes/suicidal thoughts/non-fatal suicidal behavior compared to those without death wishes in Barnow’s population-based study set in Germany [27].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Barnow, 2004, The relation between suicidal feelings and mental disorders in the elderly: Results from the Berlin Aging Study (BASE)., Psychol. Med. source

      Not checked in the free run.

  • Findingown data

    Only three studies (with four publications) examined suicide/fatal suicidal behavior.

    “Only three studies (with four publications) examined suicide/fatal suicidal behavior [38,40,41,42].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [38] Tsoh, 2005, Attempted suicide in elderly Chinese persons: A multi-group, controlled study, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [40] Rubenowitz, 2001, Life events and psychosocial factors in elderly suicides—A case-control study, Psychol. Med. source

      Not checked in the free run.

    • cites [41] Turvey, 2002, Risk factors for late-life suicide: A prospective community-based study, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [42] Waern, 2003, Predictors of suicide in the old elderly, Gerontology source

      Not checked in the free run.

  • Findingcitation

    Not having a current partner was associated with death wishes in a Canadian community-based study.

    “Not having a current partner was associated with death wishes in a Canadian community-based study by Lapierre [30].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Lapierre, 2012, Daily hassles, physical illness, and sleep problems in older adults with wishes to die, Int. Psychogeriatr. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. 19
  • May combine two claims. 18

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The combined searches yielded 23,299 references.

    “The combined searches yielded 23,299 references.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Only 16 publications met inclusion criteria, and these publications were based on data from a total of 14 studies.

    “Our search identified only 16 articles (across 14 independent samples) that met inclusion criteria.”
    • Also stated in: § 2. Method · plain
      “Only 16 publications met the inclusion criteria, and these publications were based on data from a total of 14 studies.”
    • Also stated in: § 4. Discussion · plain
      “This systematic review yielded 16 publications on social factors and suicidal behaviors in persons aged 65 and above.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Factors related to self-harm/non-fatal suicidal behavior were examined in six studies.

    “Factors related to self-harm/non-fatal suicidal behavior were examined in six studies [27,35,36,37,38,39].”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [27] Barnow, 2004, The relation between suicidal feelings and mental disorders in the elderly: Results from the Berlin Aging Study (BASE)., Psychol. Med. source

      Not checked in the free run.

    • cites [35] Conaghan, 2002, Hopelessness and the anticipation of positive and negative future experiences in older parasuicidal adults, Br. J. Clin. Psychol. source

      Not checked in the free run.

    • cites [36] Dennis, 2005, Self-harm in older people with depression: Comparison of social factors, life events and symptoms, Br. J. Psychiatry source

      Not checked in the free run.

    • cites [37] Takahashi, 1995, Suicide and aging in Japan: An examination of treated elderly suicide attempters, Int. Psychogeriatr. source

      Not checked in the free run.

    • cites [38] Tsoh, 2005, Attempted suicide in elderly Chinese persons: A multi-group, controlled study, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [39] Wiktorsson, 2010, Attempted suicide in the elderly: Characteristics of suicide attempters 70 years and older and a general population comparison group, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Marital status was examined in eleven studies.

    “Marital status was examined in eleven studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Significant effects on non-fatal suicidal behavior were observed in the Dennis study, and on both attempted suicide and suicide in the Tsoh study.

    “For these two studies, significant effects on non-fatal suicidal behavior were observed in the Dennis study from Great Britain [36] and on both attempted suicide and suicide in Tsoh’s Hong Kong-based study [38].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [36] Dennis, 2005, Self-harm in older people with depression: Comparison of social factors, life events and symptoms, Br. J. Psychiatry source

      Not checked in the free run.

    • cites [38] Tsoh, 2005, Attempted suicide in elderly Chinese persons: A multi-group, controlled study, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Residential change over the past two years was not associated with death by suicide in the Swedish study by Rubenowitz, nor in Waern age-stratified analyses.

    “Residential change over the past two years was not associated with death by suicide in the Swedish study by Rubenowitz [40], nor when Waern conducted separate analyses for those aged 65–74 years and those aged above 75 [42].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [40] Rubenowitz, 2001, Life events and psychosocial factors in elderly suicides—A case-control study, Psychol. Med. source

      Not checked in the free run.

    • cites [42] Waern, 2003, Predictors of suicide in the old elderly, Gerontology source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Indices of low social integration were examined in five studies.

    “Indices of low social integration were examined in five studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    No association was shown between frequency of religious activity and either death ideation or suicide ideation in U.S. primary care patients.

    “No association could be shown between frequency of religious activity and either death ideation (i.e., wishes for death) or suicide ideation in primary care patients in the U.S.-based study by Bartels [28].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [28] Bartels, 2002, Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Living with children was associated with decreased risk for both suicide attempt and death by suicide in the Tsoh Hong Kong study.

    “Living with children was associated with decreased risk for both suicide attempt and death by suicide in the above-cited study by Tsoh [38]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Tsoh, 2005, Attempted suicide in elderly Chinese persons: A multi-group, controlled study, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Contacts with children and relatives showed null results for death ideation in the Bartels study and for suicide in the Turvey study.

    “However, when specifically considering contacts with children and relatives, null results were found for death ideation (i.e., passive wishes for death) in the Bartels study [28] and for suicide in the Turvey study [41].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28] Bartels, 2002, Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [41] Turvey, 2002, Risk factors for late-life suicide: A prospective community-based study, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Both younger (65-74) and older (75+) suicide decedents were significantly less involved in organizations than sex- and age-matched comparisons in the Waern study.

    “Waern noted that both younger (65–74) and older (75+) suicide decedents were significantly less involved in such activities than sex- and age-matched comparisons from the general population [42].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42] Waern, 2003, Predictors of suicide in the old elderly, Gerontology source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Greater perceived social support was associated with lower risk for both concurrent and one-year incident death/suicide ideation.

    “However, greater perceived social support was associated with lower risk for both concurrent and one-year incident death/suicide ideation [31].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [31] Raue, 2007, Suicidal ideation among elderly homecare patients, Int. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    No association between living alone and suicide was found in the Rubenowitz study, with similar results for men and women.

    “No such association was found, however in the Rubenowitz study that focused on suicide in the same region [40] and similar results were observed for men and women.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] Rubenowitz, 2001, Life events and psychosocial factors in elderly suicides—A case-control study, Psychol. Med. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Only two of eleven studies that examined living arrangement reported an association between living alone and the outcomes of interest, one from Japan and one from Sweden.

    “Only two of the eleven studies that examined living arrangement reported an association between living alone and the outcomes of interest, one from Japan [37] and another from Sweden [39].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [37] Takahashi, 1995, Suicide and aging in Japan: An examination of treated elderly suicide attempters, Int. Psychogeriatr. source

      Not checked in the free run.

    • cites [39] Wiktorsson, 2010, Attempted suicide in the elderly: Characteristics of suicide attempters 70 years and older and a general population comparison group, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Findings indicated that at least in industrialized countries, limited social connectedness is associated with suicidal ideation, non-fatal suicidal behavior, and suicide in later life.

    “Findings indicated that at least in industrialized countries, limited social connectedness is associated with suicidal ideation, non-fatal suicidal behavior, and suicide in later life.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Loneliness was associated with increased risk for both non-fatal and fatal suicidal behavior in Swedish studies.

    “Loneliness—the inner, subjective experience of social disconnectedness—was examined in two Swedish studies (across three publications), documenting increased risk for both non-fatal and fatal suicidal behavior [39,40,42].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [39] Wiktorsson, 2010, Attempted suicide in the elderly: Characteristics of suicide attempters 70 years and older and a general population comparison group, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [40] Rubenowitz, 2001, Life events and psychosocial factors in elderly suicides—A case-control study, Psychol. Med. source

      Not checked in the free run.

    • cites [42] Waern, 2003, Predictors of suicide in the old elderly, Gerontology source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Living with children was associated with a decreased risk for both non-fatal and fatal suicidal behavior in the Hong Kong study.

    “For example, those who live with their children would belong to the group who do not live alone, and living with children was associated with a decreased risk for both non-fatal and fatal suicidal behavior in the Hong Kong study [38].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] Tsoh, 2005, Attempted suicide in elderly Chinese persons: A multi-group, controlled study, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Consistent results were found for subjective measures of social connectedness: perceived social support (two U.S. studies) and loneliness (two Swedish studies).

    “Though investigated in fewer studies, consistent results were also found for subjective measures of social connectedness—perceived social support (two U.S. studies [31,41]) and loneliness (two Swedish studies [39,40,42]).”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [31] Raue, 2007, Suicidal ideation among elderly homecare patients, Int. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [41] Turvey, 2002, Risk factors for late-life suicide: A prospective community-based study, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [39] Wiktorsson, 2010, Attempted suicide in the elderly: Characteristics of suicide attempters 70 years and older and a general population comparison group, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

    • cites [40] Rubenowitz, 2001, Life events and psychosocial factors in elderly suicides—A case-control study, Psychol. Med. source

      Not checked in the free run.

    • cites [42] Waern, 2003, Predictors of suicide in the old elderly, Gerontology source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Individuals who had engaged in suicidal behavior demonstrated significantly more errors on the Reading the Mind in the Eyes test than mentally healthy controls.

    “Specifically, individuals in the former group demonstrated significantly more errors on the Reading the Mind in the Eyes test, which measures emotion recognition capabilities by having participants make subtle discriminations between photographs of facial expressions.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [72] Szanto, 2012, Social emotion recognition, social functioning, and attempted suicide in late-life depression, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    A recent U.S. study that focused on depressed suicide attempters aged 60 and above found that social cognition deficits differentiated individuals who had engaged in suicidal behavior from mentally healthy controls.

    “A recent U.S. study that focused on depressed suicide attempters aged 60 and above found that social cognition deficits differentiated individuals who had engaged in suicidal behavior from mentally healthy controls [72].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [72] Szanto, 2012, Social emotion recognition, social functioning, and attempted suicide in late-life depression, Am. J. Geriatr. Psychiatry source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Results from a qualitative study focusing on U.S. older women showed that those who were suicidal experienced loneliness in childhood, and no confidants during adolescence and adulthood.

    “Results from a qualitative study focusing on U.S. older women showed that those who were suicidal experienced loneliness in childhood, and no confidants during adolescence and adulthood [71].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [71] Haight, 1998, Suicidal intent/life satisfaction: Comparing the life stories of older women, Suicide Life Threat. Behav. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Guidelines from the Cochrane Collaboration were used for this systematic review.

    “Guidelines from the Cochrane Collaboration were used for this systematic review [26].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Higgins, J.P.T., and Green, S. (2008). Cochrane Handbook for Systematic Reviews of Interventions, John Wiley & Sons, Ltd. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisereasoning

    Social factors alone are insufficient to explain the etiology of suicidal behavior.

    “Another theme is that social factors alone are insufficient to explain the etiology of suicidal behavior.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisereasoning

    Positive social connections may be protective against suicide, whereas discordant or overly strong/enmeshed connections may elevate risk for suicide.

    “Common themes from these diverse theorists are that positive social connections may be protective against suicide, whereas discordant or overly strong/enmeshed connections may elevate risk for suicide.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The gender gap in suicide mortality is less pronounced in Asian countries.

    “with the gender gap in suicide mortality less pronounced in Asian countries [3]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Hawton, K., and van Heeringen, K. (2000). The international Handbook of Suicide and Attempted Suicide, Wiley. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Psychological autopsy studies indicate mental disorder is present in 71-97% of older adults who die by suicide, with depression as the most common diagnosis.

    “mental disorder is present in 71–97% of older adults who die by suicide with depression as the most common diagnosis [2]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Conwell, 2011, Suicide in older adults, Psychiatr. Clin. N. Am. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    It cannot be assumed that death wishes, suicide ideation, non-fatal and fatal suicidal behavior share the same risk factors.

    “It cannot be assumed that these phenomena share the same risk factors.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There are gender-related differences in the link between physical illness and suicide.

    “just as there are gender-related differences in the link between physical illness and suicide [51].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Waern, M., Rubenowitz, E., Runeson, B., Skoog, I., Wilhelmson, K., and Allebeck, P. (2002). Burden of illness and suicide in elderly people: Case-control study. Br. Med. J., 324. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The review included a broadly defined range of suicidal behaviors (death wishes, suicide ideation, non-fatal and fatal suicidal behavior).

    “We included a broadly defined range of suicidal behaviors (death wishes, suicide ideation, non-fatal and fatal suicidal behavior).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    This apparent heterogeneity is systematically moderated by macro- or national-level influences, for example, cultural scripts of gender and suicidal behavior, that the review did not examine.

    “This apparent heterogeneity is systematically moderated by macro- or national-level influences, for example, cultural scripts of gender and suicidal behavior [49] that we did not examine.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49] Canetto, 1992–1993, She died for love and he for glory: Gender myths of suicidal behavior, Omega

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Other research indicates stronger benefits for giving versus receiving support.

    “Other research indicates stronger benefits for giving versus receiving support [60].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60] Thomas, 2010, Is it better to give or to receive? Social support and the well-being of older adults, J. Gerontol. B source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Primary prevention programs of greatest demonstrable relevance to suicide in communities where firearms and medications are dominant suicide methods include legislation restricting access to unsafe firearms as well as mandates concerning the manufacturing, packaging, and distribution of medications.

    “Primary prevention programs of greatest demonstrable relevance to suicide in communities where firearms and medications are dominant suicide methods include legislation restricting access to unsafe firearms as well as mandates concerning the manufacturing, packaging, and distribution of medications [93,94].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [93] Hawton, 2002, United Kingdom legislation on pack sizes of analgesics: Background, rationale, and effects on suicide and deliberate self-harm, Suicide Life Threat. Behav. source

      Not checked in the free run.

    • cites [94] Hawton, K., Bergen, H., Simkin, S., Brock, A., Griffiths, C., Romeri, E., Smith, K.L., Kapur, N., and Gunnell, D. (2009). Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: Time series analysis. Br. Med. J., 338. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    If the need to belong is thwarted and the individual has a perception of being a burden on others, this will result in a desire for suicide.

    “If this need is thwarted, and the individual has a perception of being a burden on others, this will result in a desire for suicide.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Witte, 2010, The interpersonal theory of suicide, Psychol. Rev. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Individuals have intrinsic needs to belong to meaningful relationships and groups.

    “The Interpersonal Theory of Suicide [16] proposes that individuals have intrinsic needs to belong to meaningful relationships and groups.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] Witte, 2010, The interpersonal theory of suicide, Psychol. Rev. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Primary prevention programs designed to enhance social connections as well as a sense of community could potentially decrease suicide risk.

    “Primary prevention programs designed to enhance social connections as well as a sense of community could potentially decrease suicide risk.”
    Quote in the paperNot a substantial claim
35 of 35

  • The paper relies on this without support.

    Before this review, no systematic review had focused specifically on social factors and suicidal behavior in older adults.

    “we are aware of no systematic review focusing specifically on social factors and suicidal behavior in this age group.”

  • The paper relies on this without support.

    Rates of suicidal behavior and social factors associated with such behavior vary widely by geographic region.

    “The rationale for this was that rates of suicidal behavior and social factors associated with such behavior vary widely by geographic region.”

  • The paper relies on this without support.

    Religious centers may in some settings provide important occasions for social interaction.

    “Participation in religious activities was also included, as religious centers may in some settings provide important occasions for social interaction.”

  • The paper relies on this without support.

    Paucity of specialized mental health services is a major problem in suicide prevention.

    “Major problems in suicide prevention are the paucity of specialized mental health services and the reluctance of many at-risk people, especially men, to avail themselves of treatment due to stigma [91] and social norms [92].”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Claim of reduced suicide risk by sex contradicts Table 1

    Major

    The text says the Rubenowitz study found decreased suicide risk among men and women who participated in organizations. Table 1 marks the study's sex-specific club-membership findings as not significant.

  • Age range for Waern's younger group differs between text and table

    Minor

    The text defines Waern's younger group as ages 65-74, while Table 1 labels it 65-75.

  • Relationship discord is counted in three publications but described in four

    Minor

    The stated count of three publications corresponds to references [38,40,42]. The same discussion also describes a relationship-discord finding from Tan [33], making four publications.

3 of 3

The citation lists haven’t been fetched yet

References 97 · Cited by 342

Research works printed but not linked: 1

  1. Rose, G. (1992). The Strategy of Prevention Medicine, Oxford University Press.

Authors
Fässberg, M. M., Orden, K. A. V., Duberstein, P., Erlangsen, A., Lapierre, S., Bodner, E., Canetto, S. S., Leo, D. D., Szanto, K., & Waern, M.
Affiliations
  • University of Gothenburg (SE)
  • University of Rochester Medicine (US)
  • Johns Hopkins University (US)
  • Université du Québec à Trois-Rivières (CA)
  • Bar-Ilan University (IL)
  • Colorado State University (US)
  • Griffith University (AU)
  • Western Psychiatric Institute and Clinic, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15260, USA
  • Department of Psychiatry and Neurochemistry, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 15, 41345 Gothenburg, Sweden
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2012-03-01
Volume
9
Issue
3
Pages
722-745
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph9030722
PMC
PMC3367273
OpenAlex
W2150230435
Semantic Scholar
40b9dcb49771018fb06b41be373b58bf4fa4d82b
Cited by
342
References
97
Citations by year
2026: 16 · 2025: 29 · 2024: 20 · 2023: 21 · 2022: 29 · 2021: 40 · 2020: 37 · 2019: 25 · 2018: 17 · 2017: 22 · 2016: 22 · 2015: 25 · 2014: 19 · 2013: 18 · 2012: 2
FWCI
2.98
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • ANU Open Research (Australian National University) (submittedVersion)
  • Griffith Research Online (submittedVersion, cc-by)
Funders
  • International Association for Suicide Prevention
  • Vetenskapsrådet (K2009-62X-21079-01-3)
  • National Institutes of Health (5t32mh020061-25)
  • National Institute of Mental Health (T32 MH20061, K23MH096936, T32-MH020061)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Health › Health disparities and outcomes
Keywords
suicide, older adults, suicidal ideation, social connectedness, social factors, suicide prevention, community, men, family and social relationships
MeSH terms
Aged, Humans, Risk Factors, Social Environment, Suicide

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review