Skip to main content

Passive Suicidal Ideation in Older Adults from 12 European Countries

Abstract

The current study provides the most recent information about the prevalence of passive suicidal ideation among European older adults and potential risk factors associated with passive suicidal ideation. This study used a cross-sectional analysis using data sampled from the Survey of Health, Ageing and Retirement in Europe (SHARE) Wave 7; data were collected in 2017. The study sample consisted of 4,378 older adults aged between 65 and 100 years (mean = 74.82 years, SD = 7.33) from 12 European countries. Risk factors included socio-demographic variables, health conditions, subjective well-being, and psychological distress. The dependent variable was passive suicidal ideation. Data were analyzed using binary logistic regression. The highest rates of passive suicidal ideation were observed in those who were female, younger, married, and living in rural areas. Older adults who reported poor health, more limitations in daily activities, and a greater level of depression and loneliness tended to experience passive suicidal ideation; older adults who reported a higher level of life satisfaction and material living, had more children, and engaged in frequent physical activities were less likely to report passive suicidal ideation. In order to diminish the likelihood of suicidal thoughts, national- and state-level policies should integrate psychological and behavioral interventions in elderly care practice to help older adults cope with psychological distress and health problems. Local governments should increase suicide awareness, foster local support groups, and promote suicide prevention/intervention programs for older adults with passive suicide ideation or those who seek help.

This is a preview of subscription content, access via your institution.

Chart 1
Chart 2

References

  • Alves, V. D. M., Maia, A. C. C., & Nardi, A. E. (2014). Suicide among elderly: A systematic review. MedicalExpress, 1(1), 9–13.

    Google Scholar 

  • Ayalon, L. (2011). The prevalence and predictors of passive death wishes in Europe: A 2-year follow-up of the survey of health, ageing, and retirement in Europe. International Journal of Geriatric Psychiatry, 26(9), 923–929.

    Article  Google Scholar 

  • Ayalon, L., & Litwin, H. (2009). What cognitive functions are associated with passive suicidal ideation? Findings from a national sample of community dwelling Israelis. International Journal of Geriatric Psychiatry: A Journal of the Psychiatry of Late Life and Allied Sciences, 24(5), 472–478.

    Article  Google Scholar 

  • Baca-Garcia, E., Perez-Rodriguez, M. M., Oquendo, M. A., Keyes, K. M., Hasin, D. S., Grant, B. F., & Blanco, C. (2011). Estimating risk for suicide attempt: Are we asking the right questions?: Passive suicidal ideation as a marker for suicidal behavior. Journal of Affective Disorders, 134(1–3), 327–332.

    Article  Google Scholar 

  • Barry, L. C. (2019). Passive suicidal ideation in older adults: Implications for suicide prevention. The American Journal of Geriatric Psychiatry, 27(12), 1411–1413.

    Article  Google Scholar 

  • Bergmann, M., Scherpenzeel, A., & Börsch-Supan, A. (Eds.). (2019). SHARE Wave 7 Methodology: Panel Innovations and Life Histories. Munich Center for the Economics of Aging (MEA).

    Google Scholar 

  • Bernier, S., Lapierre, S., & Desjardins, S. (2020). Social interactions among older adults who wish for death. Clinical Gerontologist, 43(1), 4–16.

    Article  Google Scholar 

  • Bertolote, J. M., & Fleischmann, A. (2009). A global perspective on the magnitude of suicide mortality. In D. Wasserman & C. Wasserman (Eds.), Oxford textbook of suicidology and suicide prevention: A global perspective (pp. 91–98). Oxford University Press.

    Chapter  Google Scholar 

  • Britton, P. C., Duberstein, P. R., Conner, K. R., Heisel, M. J., Hirsch, J. K., & Conwell, Y. (2008). Reasons for living, hopelessness, and suicide ideation among depressed adults 50 years or older. The American Journal of Geriatric Psychiatry, 16(9), 736–741.

    Article  Google Scholar 

  • Börsch-Supan, A. (2020). Survey of health, ageing and retirement in Europe (SHARE) Wave 7. Release version: 7.1.1. SHARE-ERIC. Data set. https://doi.org/10.6103/SHARE.w7.711

  • Brooks, S. E., Burruss, S. K., & Mukherjee, K. (2019). Suicide in the elderly: A multidisciplinary approach to prevention. Clinics in Geriatric Medicine, 35(1), 133–145.

    Article  Google Scholar 

  • Cabello, M., Miret, M., Ayuso-Mateos, J. L., Caballero, F. F., Chatterji, S., Tobiasz-Adamczyk, B., ... & Borges, G. (2020). Cross-national prevalence and factors associated with suicide ideation and attempts in older and young-and-middle age people. Aging & Mental Health24(9), 1533-1542

  • Cano-Montalbán, I., & Quevedo-Blasco, R. (2018). Sociodemographic variables most associated with suicidal behaviour and suicide methods in Europe and America. A systematic review. The European Journal of Psychology Applied to Legal Context, 10(1), 15–25.

    Article  Google Scholar 

  • Carlo, C., Vittoria, M., Natalia, C., Maria, L. S., & Rossana, C. (2019). Suicide in the elderly: A 37-years retrospective study. Acta Bio Medica: Atenei Parmensis, 90(1), 68.

    Google Scholar 

  • Chang, Q., Chan, C. H., & Yip, P. S. (2017). A meta-analytic review on social relationships and suicidal ideation among older adults. Social Science & Medicine, 191, 65–76.

    Article  Google Scholar 

  • Cheung, F., & Lucas, R. E. (2014). Assessing the validity of single-item life satisfaction measures: Results from three large samples. Quality of Life Research, 23(10), 2809–2818.

    Article  Google Scholar 

  • Conejero, I., Olié, E., Courtet, P., & Calati, R. (2018). Suicide in older adults: Current perspectives. Clinical Interventions in Aging, 13, 691.

    Article  Google Scholar 

  • Cosh, S., Carrière, I., Daien, V., Tzourio, C., Delcourt, C., & Helmer, C. (2019). Sensory loss and suicide ideation in older adults: Findings from the Three-City cohort study. International Psychogeriatrics, 31(1), 139–145.

    Article  Google Scholar 

  • Cukrowicz, K. C., Cheavens, J. S., Van Orden, K. A., Ragain, R. M., & Cook, R. L. (2011). Perceived burdensomeness and suicide ideation in older adults. Psychology and Aging, 26(2), 331.

    Article  Google Scholar 

  • De Leo, D., Krysinska, K., Bertolote, J. M., Fleischman, A., & Wasserman, D. (2009). Suicidal behaviors on all the continents among the elderly. In D. Wasserman & C. Wasserman (Eds.), Oxford textbook of suicidology and suicide prevention (pp. 693–701). Oxford University Press.

    Chapter  Google Scholar 

  • Demir, M. (2018). Who commits suicide most? Suicide by gender and age. Forensic Research and Criminology International Journal, 6(6), 505–510.

    Article  Google Scholar 

  • Desseilles, M., Perroud, N., Guillaume, S., Jaussent, I., Genty, C., Malafosse, A., & Courtet, P. (2012). Is it valid to measure suicidal ideation by depression rating scales? Journal of Affective Disorders, 136(3), 398–404.

    Article  Google Scholar 

  • Erlangsen, A., Bille-Brahe, U., & Jeune, B. (2003). Differences in suicide between the old and the oldest old. The Journals of Gerontology Series b: Psychological Sciences and Social Sciences, 58(5), S314–S322.

    Article  Google Scholar 

  • Fässberg, M. M., Vanaelst, B., Jonson, M., Sterner, T. R., Ahlner, F., Wetterberg, H., ... & Waern, M. (2020). Epidemiology of suicidal feelings in an ageing Swedish population: From old to very old age in the Gothenburg H70 Birth Cohort Studies. Epidemiology and Psychiatric Sciences, 29(e26), 1–14. https://doi.org/10.1017/S2045796019000143.

  • Foroughan, M., Rostami, M., & Jalal Younesi, S. (2021). Determinants of suicidal ideation among older adults: A cross-sectional survey in Iran. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 34(2), 91–99. https://doi.org/10.1024/1662-9647/a000250.

  • Fujita, F., Diener, E., & Sandvik, E. (1991). Gender differences in negative affect and well-being: The case for emotional intensity. Journal of Personality and Social Psychology, 61(3), 427.

    Article  Google Scholar 

  • Ge, D., Sun, L., Zhou, C., Qian, Y., Zhang, L., & Medina, A. (2017). Exploring the risk factors of suicidal ideation among the seniors in Shandong, China: a path analysis. Journal of Affective Disorders, 207, 393–397.

  • Girgus, J. S., Yang, K., & Ferri, C. V. (2017). The gender difference in depression: Are elderly women at greater risk for depression than elderly men? Geriatrics, 2(4), 35.

    Article  Google Scholar 

  • Hamilton, M. (1980). Rating depressive patients. The Journal of Clinical Psychiatry, 41(12, Sec 2), 21–24.

    Google Scholar 

  • Heisel, M. J., & Duberstein, P. R. (2005). Suicide prevention in older adults. Clinical Psychology: Science and Practice, 12(3), 242–259.

    Google Scholar 

  • Heisel, M. J., & Flett, G. L. (2008). Psychological resilience to suicide ideation among older adults. Clinical Gerontologist, 31(4), 51–70.

    Article  Google Scholar 

  • Heisel, M. J., & Flett, G. L. (2020). Screening for suicide risk among older adults: assessing preliminary psychometric properties of the Brief Geriatric Suicide Ideation Scale (BGSIS) and the GSIS-Screen. Aging & Mental Healthhttps://doi.org/10.1080/13607863.2020.1857690.

  • Heisel, M. J., Neufeld, E., & Flett, G. L. (2016). Reasons for living, meaning in life, and suicide ideation: Investigating the roles of key positive psychological factors in reducing suicide risk in community-residing older adults. Aging & Mental Health, 20(2), 195–207.

    Article  Google Scholar 

  • Heuser, C., & Howe, J. (2019). The relation between social isolation and increasing suicide rates in the elderly. Quality in Ageing and Older Adults.

  • Høyer, G., & Lund, E. (1993). Suicide among women related to number of children in marriage. Archives of General Psychiatry, 50(2), 134–137.

    Article  Google Scholar 

  • Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging, 26(6), 655–672.

    Article  Google Scholar 

  • Hyde, M., Wiggins, R. D., Higgs, P., & Blane, D. B. (2003). A measure of quality of life in early old age: the theory, development and properties of a needs satisfaction model (CASP-19). Aging & Mental Health, 7(3), 186–194.

  • Innamorati, M., Tamburello, A., Lester, D., Amore, M., Girardi, P., Tatarelli, R., & Pompili, M. (2010). Inequalities in suicide rates in the European Union’s elderly: Trends and impact of macro-socioeconomic factors between 1980 and 2006. The Canadian Journal of Psychiatry, 55(4), 229–238.

    Article  Google Scholar 

  • Joiner, T. E. (2007). Why people die by suicide. Harvard University Press.

    Book  Google Scholar 

  • Joiner, T. E., Van Orden, K. A., Witte, T. K., Selby, E. A., Ribeiro, J. D., Lewis, R., & Rudd, M. D. (2009). Main predictions of the interpersonal–psychological theory of suicidal behavior: Empirical tests in two samples of young adults. Journal of Abnormal Psychology, 118(3), 634.

    Article  Google Scholar 

  • Kim, S., Ha, J., Yu, J., Park, D., & Ryu, S. (2014). Path analysis of suicide ideation in older people. International Psychogeriatrics, 26(3), 509–515. https://doi.org/10.1017/S1041610213002366

    Article  Google Scholar 

  • Klonsky, E. D., & May, A. M. (2015). The three-step theory (3ST): A new theory of suicide rooted in the “ideation-to-action” framework. International Journal of Cognitive Therapy, 8(2), 114–129.

    Article  Google Scholar 

  • Klonsky, E. D., May, A. M., & Saffer, B. Y. (2016). Suicide, suicide attempts, and suicidal ideation. Annual Review of Clinical Psychology, 12, 307–330.

    Article  Google Scholar 

  • Koo, Y. W., Kõlves, K., & De Leo, D. (2017). Suicide in older adults: A comparison with middle-aged adults using the Queensland Suicide Register. International Psychogeriatrics, 29(3), 419.

    Article  Google Scholar 

  • Lukaschek, K., Engelhardt, H., Baumert, J., & Ladwig, K. H. (2015). No correlation between rates of suicidal ideation and completed suicides in Europe: Analysis of 49,008 participants (55+ years) based on the Survey of Health, Ageing and Retirement in Europe (SHARE). European Psychiatry, 30(7), 874–879.

    Article  Google Scholar 

  • Lutz, J., Morton, K., Turiano, N. A., & Fiske, A. (2016). Health conditions and passive suicidal ideation in the survey of health, ageing, and retirement in Europe. Journals of Gerontology Series b: Psychological Sciences and Social Sciences, 71(5), 936–946.

    Article  Google Scholar 

  • Lutzman, M., Sommerfeld, E., & Ben-David, S. (2021). Loneliness and social integration as mediators between physical pain and suicidal ideation among elderly men. International Psychogeriatrics, 33(5), 453–459. https://doi.org/10.1017/S104161022000112X.

  • Makara-Studzińska, M., Somasundaram, S. G., Halicka, J., Madej, A., Leszek, J., Rehan, M., ... & Aliev, G. (2021). Suicide and suicide attempts in the elderly patients: an epidemiological analysis of risk factors and prevention. Current Pharmaceutical Design, 27(19), 2231–2236. https://doi.org/10.2174/1381612826999201126202008.

  • Malter, F., Schuller, K., & Börsch-Supan, A. (2018). SHARE compliance profiles – Wave 7. MEA, Max Planck Institute for Social Law and Social Policy.

    Google Scholar 

  • May, A. M., & Klonsky, E. D. (2016). What distinguishes suicide attempters from suicide ideators? A meta‐analysis of potential factors. Clinical Psychology: Science and Practice, 23(1), 5–20. https://doi.org/10.1037/h0101735.

  • McClelland, H., Evans, J. J., Nowland, R., Ferguson, E., & O'Connor, R. C. (2020). Loneliness as a predictor of suicidal ideation and behaviour: a systematic review and meta-analysis of prospective studies. Journal of Affective Disorders, 274, 880–896. https://doi.org/10.1016/j.jad.2020.05.004.

  • McHugh, C., Corderoy, A., Ryan, C., Hickie, I., & Large, M. (2019). Association between suicidal ideation and suicide: Meta-analyses of odds ratios, sensitivity, specificity and positive predictive value. BJPsych Open, 5(2), E18. https://doi.org/10.1192/bjo.2018.88.

  • Oonarom, A., Wongpakaran, T., Kuntawong, P., & Wongpakaran, N. (2021). Attachment anxiety, depression, and perceived social support: A moderated mediation model of suicide ideation among the elderly. International Psychogeriatrics, 33(2), 169–178. https://doi.org/10.1017/S104161022000054X.

  • O’Riley, A. A., Van Orden, K., & Conwell, Y. (2014). Suicidal ideation in late life. In N. A. Pachana & K. Laidlaw (Eds.), Oxford library of psychology. The Oxford handbook of clinical geropsychology (pp. 267–284). Oxford University Press.

    Google Scholar 

  • Prince, M. J., Reischies, F., Beekman, A. T., Fuhrer, R., Jonker, C., Kivela, S. L., ... & Copeland, J. R. (1999). Development of the EURO–D scale–a European Union initiative to compare symptoms of depression in 14 European centres. The British Journal of Psychiatry174(4), 330–338

  • Pompili, M., O'Connor, R. C., & Van Heeringen, K. (2020). Suicide prevention in the European Region. Crisis, 41, S8-S20. https://doi.org/10.1027/0227-5910/a000665.

  • Raue, P. J., Morales, K. H., Post, E. P., Bogner, H. R., Ten Have, T., & Bruce, M. L. (2010). The wish to die and 5-year mortality in elderly primary care patients. The American Journal of Geriatric Psychiatry, 18(4), 341–350.

    Article  Google Scholar 

  • Ricarte Trives, J., Navarro Bravo, B., Latorre Postigo, J., Ros Segura, L., & Watkins, E. (2016). Age and gender differences in emotion regulation strategies: Autobiographical memory, rumination, problem solving and distraction. The Spanish Journal of Psychology, 19, E43. https://doi.org/10.1017/sjp.2016.46.

  • Rudd, M. D., Berman, A. L., Joiner Jr, T. E., Nock, M. K., Silverman, M. M., Mandrusiak, M., ... & Witte, T. (2006). Warning signs for suicide: Theory, research, and clinical applications. Suicide and Life-Threatening Behavior36(3), 255–262

  • Santini, Z. I., Koyanagi, A., Tyrovolas, S., & Haro, J. M. (2015). The association of relationship quality and social networks with depression, anxiety, and suicidal ideation among older married adults: Findings from a cross-sectional analysis of the Irish Longitudinal Study on Ageing (TILDA). Journal of Affective Disorders, 179, 134–141.

    Article  Google Scholar 

  • Sharp, R. (2015). The Hamilton rating scale for depression. Occupational Medicine, 65(4), 340–340.

    Article  Google Scholar 

  • Silverman, M. M., & Berman, A. L. (2014). Suicide risk assessment and risk formulation part I: A focus on suicide ideation in assessing suicide risk. Suicide and Life-Threatening Behavior, 44(4), 420–431.

    Article  Google Scholar 

  • Stolz, E., Fux, B., Mayerl, H., Rásky, É., & Freidl, W. (2016). Passive suicide ideation among older adults in Europe: A multilevel regression analysis of individual and societal determinants in 12 countries (SHARE). Journals of Gerontology Series b: Psychological Sciences and Social Sciences, 71(5), 947–958.

    Article  Google Scholar 

  • Thomsen, D. K., Mehlsen, M. Y., Viidik, A., Sommerlund, B., & Zachariae, R. (2005). Age and gender differences in negative affect—Is there a role for emotion regulation? Personality and Individual Differences, 38(8), 1935–1946.

    Article  Google Scholar 

  • Van Orden, K., & Conwell, Y. (2011). Suicides in late life. Current Psychiatry Reports, 13(3), 234–241.

    Article  Google Scholar 

  • Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E., Jr. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575.

    Article  Google Scholar 

  • Van Orden, K. A., O’Riley, A. A., Simning, A., Podgorski, C., Richardson, T. M., & Conwell, Y. (2015). Passive suicide ideation: An indicator of risk among older adults seeking aging services? The Gerontologist, 55(6), 972–980.

    Article  Google Scholar 

  • Ware Jr, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30(6), 473–483. https://www.jstor.org/stable/3765916.

  • Wongpakaran, N., Wongpakaran, T., Lerttrakarnnon, P., Jiraniramai, S., Sirirak, T., Assanangkornchai, S., ... & Kuntawong, P. (2019). Prevalence, clinical and psychosocial variables of depression, anxiety and suicidality in geriatric tertiary care settings. Asian Journal of Psychiatry41, 38–44

  • Zhang, L., Sun, L., Zhou, C., Ge, D., & Qian, Y. (2018). The relationship between difficulties in daily living and suicidal ideation among older adults: Results from a population-based survey in Shandong. The Journal of Nervous and Mental Disease, 206(3), 211.

    Article  Google Scholar 

Download references

Acknowledgements

This paper uses data from SHARE Wave 7 (DOIs: https://doi.org/10.6103/SHARE.w7.711); see Börsch-Supan et al. (2013) for methodological details. The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N°211909, SHARE-LEAP: GA N°227822, SHARE M4: GA N°261982, DASISH: GA N°283646) and Horizon 2020 (SHARE-DEV3: GA N°676536, SHARE-COHESION: GA N°870628, SERISS: GA N°654221, SSHOC: GA N°823782) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C) and from various national funding sources is gratefully acknowledged (see www.share-project.org).

Funding

This research was funded by Primus Research Programme at Charles University [Primus/19/HUM/12]. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sunwoo Lee.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, S. Passive Suicidal Ideation in Older Adults from 12 European Countries. Population Ageing 16, 137–154 (2023). https://doi.org/10.1007/s12062-021-09350-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12062-021-09350-6

Keywords