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Sunday, July 28, 2002



Suicide rates
rise for seniors

Data show more than 15%
of isle suicides from 1991
to 2001 were elderly people

Danger signs


Staff and news reports

Across the nation, senior citizens are committing suicide at higher rates than any other age group, according to national health experts.

The latest national statistics show that Americans 65 and older account for about 13 percent of the population but almost a fifth of all suicides. The national rate is 11 suicides for every 100,000 people, about the same for teens. But the risk steadily rises with age. Most at risk are older white men: 33 of every 100,000 of them commit suicide every year, translating to 4,655 suicides in 1998 alone.

In Hawaii, however, officials said they are not sure if the state is above, below or on par with the national average because information about such deaths is often unreliable.

"It's something people don't like to talk about," said Marilyn Seely, director of the state's Executive Office on Aging. "But what we know is that there is a lot of depression at the end of life just because of the failing health conditions and the pressures put upon people and their families.

"We suspect that there are more suicides than are reported because of these conditions."

Last year in Hawaii, the state Health Department recorded 23 suicides of residents and nonresidents ages 65 and older. From 1991 to 2001, 236 elderly suicides were recorded, more than 15 percent of the total 1,526 recorded suicides in Hawaii over the same period, according to the department's figures.

And that's only those cases which health officials know about.

"Families will usually say something else, the accuracy isn't there," said Seely. "We'd love to have better statistics.

"There's a lot of despair at the end of life over failing health and finances ... we'd need to take a survey so we know how many people are going through this."

Nationally, researchers said with Baby Boomers graying fast -- a group already more prone to suicide than other generations -- the situation could soon worsen. Now researchers are uncovering factors, such as lack of social support, poor sleep patterns, and memory or other brain problems that sometimes hit seniors, that could help primary care physicians spot elderly patients at risk of suicide and intervene.

According to Dr. Allan Anderson, a geriatric psychiatrist in Cambridge, Md., it's a difficult situation to diagnose. Many of today's seniors are the generation of the stiff upper lip when it comes to mental health.

Ask how they're feeling and you may hear a litany about aching joints, but they're far less likely than younger people to admit to depression, said Anderson.

That leaves doctors and loved ones to notice subtle clues like a senior not discussing a much-beloved hobby anymore, or to struggle to help the elderly surmount a daunting physical loss, like one of Anderson's patients who had no family to lean on when his vision faded.

Most are not terminally ill, and thus these are largely preventable deaths, insists Dr. Yeates Conwell, a University of Rochester specialist in elderly suicide.

"We tend to seek the simple solution: Mr. Smith killed himself because his wife died or Mrs. Jones killed herself because she was diagnosed with cancer," but that's seldom the real reason, said Dr. Yeates Conwell, a University of Rochester specialist in elderly suicide. "We have to go beyond simple explanations and start looking ... at the tapestry of older people's lives."

New research reported in this month's American Journal of Geriatric Psychiatry shows while depression is a clear risk at any age, there are some special senior warning signs. No specific illness was associated with suicide, but perceived poor health is -- as is poor sleep quality and having fewer friends or relatives to confide in. Memory or other brain problems may play a role, too.

Whatever the cause, senior suicide attempts are strikingly lethal. Four elders attempt suicide for each who succeeds. That compares with 200 attempts per completed suicide among young adults, who may have planned the attempt less carefully or may have more family or friends around to find and revive them.

Worsening the problem is the myth that it's normal to feel sad or depressed when you get old. Too often, Conwell laments, even doctors believe that myth and don't diagnose treatable depressive illnesses.

"Your doctor can only treat you if you say how you're really feeling," advises the National Institute of Mental Health.

Most seniors who commit suicide had seen a primary care physician in the previous month, and psychiatrists urge those doctors to look for clues. Ask "What thoughts have you had about suicide?" instead of the easier-to-evade "Are you depressed?" advises Anderson -- and consult a mental health specialist immediately about any patient deemed at risk.



The Associated Press and Star-Bulletin reporter
Rod Antone contributed to this report.


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Watch for the danger signs

The National Institute of Mental Health urges seniors to seek help for symptoms including:

>> Feeling nervous, "empty," worthless, tired, restless or irritable.

>> Not enjoying things like they used to, or feeling no one loves them or that life isn't worth living.

>> Eating or sleeping more or less than normal.

>> Having persistent headaches, stomachaches or chronic pain.




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