Social Psychiatry and Psychiatric Epidemiology

, Volume 50, Issue 9, pp 1427–1439 | Cite as

Physical diseases as predictors of suicide in older adults: a nationwide, register-based cohort study

  • Annette Erlangsen
  • Elsebeth Stenager
  • Yeates Conwell
Original Paper



The objective of the study was to examine the association between 39 physical diseases and death by suicide in older adults.


Individual-level register data on all older adults aged 65 years and over living in Denmark during 1990–2009 (N = 1,849,110) were analysed. Rate ratios were calculated for 39 physical diseases while adjusting for period, age group, conjugal status, income, physical comorbidity, and psychiatric disorders.


In all, 4792 older adults aged 65+ died by suicide during the follow-up of >16 million person-years. Gastrointestinal cancer was linked to a rate ratio of 2.5 (95 % CI 1.9–3.5) in men while excess suicide risk for women with brain cancer was 3.5 (95 % CI 1.1–10.8) within three years of diagnosis. Men and women diagnosed with liver diseases within three years experienced a 2.7- (95 % CI 1.7–4.2) and 4.0- (95 % CI 2.5–6.4) fold higher risk of suicide, respectively, than those not diagnosed. Elevated risks of suicide were identified for lung cancer, gastrointestinal cancer, breast cancer, genital cancer, bladder cancer, lymph node cancer, epilepsy, cerebrovascular diseases, cataract, heart diseases, chronic obstructive pulmonary disorders (COPD), gastrointestinal disease, liver disease, arthritis, osteoporosis, prostate disorders, male genital disorders, and spinal fracture when compared to persons not diagnosed within three years.


Multiple physical diseases were linked to increased risks of suicide in older adults. Increased attention to suicidal ideation and risk assessment might be warranted during the diagnosis and treatment of these disorders.


Suicide Aged Aged, 80 and Over Disease Chronic Illness Physical disease 



The current project was supported by the Danish Health Foundation, the EGV Foundation, Ejnar and AaseDanielsens Foundation, the Augustinus Foundation.

Conflict of interest


Ethical standards

The research project has been carried out in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Furthermore, the project was approved by the Danish Data Protection Agency and the Danish National Board of Health (7-505-29-1848/1). Given the nature of the data, an informed consent from subjects was not required.

Supplementary material

127_2015_1051_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 17 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Annette Erlangsen
    • 1
    • 2
  • Elsebeth Stenager
    • 3
    • 4
  • Yeates Conwell
    • 5
  1. 1.The Research UnitMental Health Centre Copenhagen and Faculty of Health SciencesCopenhagen NVDenmark
  2. 2.Department of Mental HealthJohns Hopkins School of Public HealthBaltimoreUSA
  3. 3.Institute of Regional Health ServiceUniversity of Southern DenmarkOdenseDenmark
  4. 4.The Mental Health Research UnitAabenraaDenmark
  5. 5.Department of Psychiatry, and Office for Aging, Center for the Study and Prevention of SuicideUniversity of Rochester Medical CenterRochesterUSA

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