Citation

Wulff B, Iwersen- Bergmann S, Pabel T, Puschel K. Rechtsmedizin 2014; 24(2): 103-106.

Copyright

(Copyright © 2014, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00194-014-0945-6

PMID

unavailable

Abstract

BACKGROUND: Within the public awareness suicide cases of persons older than 80 years are often regarded as a voluntary decision when the good times in life have definitely passed; however, in the medical literature chronic pain, chronic posttraumatic stress disorders, loneliness and depression have been described as the leading risk factors. These conditions are much more difficult to diagnose and treat in the elderly than in younger persons and particularly in elderly men who have a greater risk of suicide. Because the death of persons over 80 years old does not come as a surprise at the time of the examination of a corpse, especially if there are no suspicious circumstances, a considerable gray area of undiagnosed suicides with so-called soft methods among fatalities of the elderly is suspected which is difficult to estimate. Examples are deliberately causing accidents, refusal of nutrition and deliberate overdosing of medication.

METHODS: In a retrospective analysis 102 cases (14-20 per year) of suicide in persons older than 80 years between January 2008 and May 2013 were evaluated (37∈% female and 63∈% male) with respect to age and gender-specific aspects. The variation in the methods used and the development of the suicide rate of the elderly in Hamburg were of special interest. In 68∈% of women and 81∈% of men a so-called hard method was predominant and hanging was the leading cause of death in nearly one third of the cases.

DISCUSSION and conclusion: The results of this study are in agreement with the findings in the literature that elderly people, especially men, prefer hard suicide methods. Compared to the suicide rates of these age groups in Hamburg for the year 2005 those of the current sample seem to be the same for women but reduced by one half for men, at least for 2011. Whether this reflects the reality of the situation or only confuses the gray area with respect to elderly men should be investigated in future studies. This could, for example be achieved by an increase in the autopsy rate and toxicological investigations in order to recognize hidden suicides, obtain more precise suicide rates and indications for preventive strategies. © 2014 Springer-Verlag Berlin Heidelberg.

Language: de

Keywords

Risk factors; human; suicide; female; male; aged; Suicide methods; sex difference; cause of death; nutrition; hanging; Cause of death; article; major clinical study; retrospective study; Depressive disorders; Retrospective studies