title: Suicide in older adults in long-term care: 1990 to 2005.
abstract: OBJECTIVE
  To describe the characteristics associated with suicide in older persons residing in long-term care (LTC) facilities, to compare the characteristics of suicide cases in LTC with those of cases in the community, and to evaluate trends in suicide in these settings over the past 15 years.
  
  
  METHODS
  The New York City (NYC) Office of the Chief Medical Examiner (OCME).
  
  
  METHODS
  Suicide deaths in NYC from 1990 to 2005.
  
  
  METHODS
  Location and method of suicide death reported by OCME.
  
  
  METHODS
  Suicides in older persons in LTC and community-dwelling older adults were compared in terms of demographic characteristics and method used. Trends in suicide rate ratios (RRs) were examined using zero-inflated Poisson regression.
  
  
  RESULTS
  Over the study period, there were 1,771 suicides among NYC residents aged 60 and older: 47 in LTC and 1,724 in the community. Cases in LTC tended to be older (P<.02) but did not differ from community cases in terms of race or sex. Suicides in LTC were significantly less likely (RR=0.05, P<.002) to be due to firearms and 2.49 times as likely to be due to a long fall (P<.002) as community cases. Over the 15-year period, there was a significant decrease in the relative rate of suicide in community-dwelling adults (RR=0.97, P<.001) but no change in residents of LTC (RR=1.05, P<.17).
  
  
  CONCLUSIONS
  Suicide risk in community-dwelling older adults has declined over the past 15 years but has not changed in LTC facilities. This suggests that prevention efforts may not be reaching this population effectively.
authors.affiliation: Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA. bmezuk@umich.edu
authors.forename: Briana
authors.initials: B
authors.lastname: Mezuk
authors.forename: Marta R
authors.initials: MR
authors.lastname: Prescott
authors.forename: Kenneth
authors.initials: K
authors.lastname: Tardiff
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data* / Q000639:trends; D000092864:Suicide Prevention