title: Community-based suicide prevention through group activity for the elderly successfully reduced the high suicide rate for females.
abstract: The lack of social support is the most common risk factor for late-life suicide. Few previous community-based interventions against the lack of social relationships reduced suicide. This study aims to evaluate outcomes of a community-based prevention program against suicide amongst the elderly in rural Japan. During 1995-2002, the program based on population strategy including group activity, psychoeducation and self-assessment of depression but no screening for depression, was implemented for elderly residents in Yuri town, Japan (5-year average population 6817; 5-year average suicide rate [> or =65 years old] 291.4/10(5)). Changes in the relative risk of suicide for individuals (> or =65 years old) before and after the 8-year implementation were estimated by the incidence rate ratio (IRR), using a quasi-experimental design with a neighboring reference, Chokai town, Japan (5-year average population 8136; 5-year average suicide rate [> or =65 years old] 216.5/10(5)). The risk of elderly females in Yuri completing suicide was reduced by 76% (age-adjusted IRR, 0.24; 95% CI, 0.10-0.58), while there was no change in the risks for Yuri's elderly males and both Chokai's elderly males and females. General loglinear analysis estimated a ratio of the female IRR in Yuri to that in its Akita prefecture of 0.35 (95% CI, 0.14-0.84), showing that the reduction of the risk in the intervention area was greater than a historical trend. A community-based suicide prevention through a group intervention designed to increase knowledge and to cultivate social relationships would be effective for elderly females but not males.
authors.affiliation: Department of Human Welfare, Ritsumeikan University, Kyoto, Japan. h_oyama@auhw.ac.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Oyama
authors.forename: Naoki
authors.initials: N
authors.lastname: Watanabe
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ono
authors.forename: Tomoe
authors.initials: T
authors.lastname: Sakashita
authors.forename: Yuka
authors.initials: Y
authors.lastname: Takenoshita
authors.forename: Manabu
authors.initials: M
authors.lastname: Taguchi
authors.forename: Tohru
authors.initials: T
authors.lastname: Takizawa
authors.forename: Reiko
authors.initials: R
authors.lastname: Miura
authors.forename: Keiko
authors.initials: K
authors.lastname: Kumagai
mesh_terms: D000367:Age Factors; D000368:Aged / Q000523:psychology*; D003153:Community Health Services; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D015397:Program Evaluation; D018570:Risk Assessment; D012737:Sex Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D000092864:Suicide Prevention