European Journal of Ageing

, Volume 14, Issue 2, pp 143–153 | Cite as

Care service use in 2 years preceding suicide among older adults: comparison with those who died a natural death and those who lived longer

  • Leena FormaEmail author
  • Mari Aaltonen
  • Jutta Pulkki
  • Jani Raitanen
  • Pekka Rissanen
  • Marja Jylhä
Original Investigation


The aim of the study is (1) to describe and analyse health and social service use and medicine purchases in the last 2 years of life among older adults who died by suicide and (2) to compare use and purchases between three groups: those who died by suicide, died a natural death or who lived longer. Nation-wide Finnish register data were used. The data consist of 316,639 decedents who died at the age of 70 years or older in 1998–2008 and 222,967 people who lived longer. Use of hospital, long-term care and home care, and the purchase of prescribed psychotropic medications were studied for the 2-year period. Binary logistic regression analyses were applied. 1118 older adults died by suicide (0.4 % of all deaths). A majority of older adults who died by suicide had multiple somatic diseases and mental disorders, especially depression, and had contact with health and social services in the last 2 years of life. At the same level of morbidity, use of hospital and long-term care was less common among those who died by suicide than among those who died of natural causes, but more common than among those who lived longer. Those who died by suicide received less home care than those who lived longer. A high proportion of suicides occurred in the first month following hospital discharge. Health and social services should improve support for older adults with chronic diseases and depression.


Suicide Health and social service use Psychotropic drugs Last years of life Depression Finland 



The authors thank Professor Sami Pirkola for his valuable comments on the manuscript. This work was supported by Academy of Finland (250602 to MJ and 276189 to LF).


This study was funded by Academy of Finland (Grant Number 250602 to MJ and 276189 to LF).

Compliance with ethical standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Leena Forma
    • 1
    • 2
    Email author
  • Mari Aaltonen
    • 1
  • Jutta Pulkki
    • 1
  • Jani Raitanen
    • 1
    • 3
  • Pekka Rissanen
    • 1
    • 2
  • Marja Jylhä
    • 1
  1. 1.School of Health Sciences and Gerontology Research Center (GEREC)University of TampereTampereFinland
  2. 2.Institute for Advanced Social ResearchUniversity of TampereTampereFinland
  3. 3.The UKK Institute for Health Promotion ResearchTampereFinland

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