Dissertation

Disparities in suicide among the old and oldest old in Denmark

Abstract

The oldest old (80+) have over recent decades not just experiences a longer life expectancy but also improved health and living conditions. It is not known if these improvements have had an impact on the very high suicide rate among the oldest old and if the suicide patterns of the oldest old differs from the old (65-79). The purpose of this dissertation is to examine the differences in suicide trends and risks between the old and oldest old. We used individual-level register data on the entire Danish population (50+) for the analysis. Differences in trends were examined for the period 1972-1998 according to calendar year, sex ratio, civil status and suicide methods. Changes in the risk of suicide during 1994-1998 are analysed by applying event-history analysis. The association between suicide and stressful events, such as death of partner, hospitalisation with psychiatric and somatic diagnoses, was examined. In contrast to the rates of the younger elderly aged 65 79, we did not find a declining trend in the suicide rate of the oldest old aged 80 or above in this period. Further analyses of suicide trends demonstrated distinct differences between the old and the oldest old. Differences in the risk patterns for suicide between the old and the oldest old were found for all the events we studied. For men, the risk of suicide associated with somatic disorders and also with loss of partner has a tendency to increase relatively to increasing age. For psychiatric disorders and for women with regard to somatic hospitalisation, however, the risk pattern appears to be opposite. Still, psychiatric hospitalisation has the strongest impact on the suicide risk, while somatic hospitalisation explains most in absolute numbers among the suicides of the oldest old.