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Suicidal Behavior Among Elderly Inpatients: its Relation to Functional Disability and Pain

0 2 years ago

In the last few decades, the proportion of global aging population has increased considerably. According to “An Aging World 2015” report by He et al, the percentage of those aged 65 years and above has reached 8.5%. This figure is projected to rise to 17% by 2050.1 As a rapidly growing and developing country, Malaysia’s population is not aging as fast as those of developed countries such as Japan, Italy, and Germany. However, in 2021, the percentage of elderly population (over 65 years old) was 7.4%, with an increase of 0.4% compared to 2020.2 It is predicted that the current aging population in Malaysia, ie, 7%, will witness a two-fold rise by 2043.3 The 7% threshold of the total population aged 65 is indicative of an aged-nation status.

In the last few years, suicidal behavior (SB), including suicidal ideation (SI) and attempts among the elderly has witnessed an increasing trend globally. Studies show that suicide is the 10th leading cause of death in the United States, and one completed suicide was reported for every four suicidal attempts in the elderly. A suicide-related death is reported every 40 seconds. SI can be categorized as active and passive ideation. Active SI refers to the situation when the patients purposely want to end their lives through their actions, while passive SI refers to the situation when the patients have desire for death and refuse to take any measures to continue their lives.4 The latter ideation is more common among the older age group, with lifetime prevalence rates between 18.7% to 40.9%.5 However, active and passive SI can have similar manifestations in the elderly, and both conditions can alternate with each other.5 It is a well-known fact that depression is a potential risk factor for SB, commonly found among the elderly. However, the prevalence of major depressive disorder (MDD) varies according to several factors, including the living environment. The prevalence ranged from 0.9% to 9.4% in private households and from 14% to 42% in institutional living.6 In the elderly population, it was observed that the depression rate is higher amongst those with underlying long-standing medical conditions.7,8 As a result, it exacerbates the patient’s medical symptom burden and increases morbidity and mortality.9


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