title: Physical diseases as predictors of suicide in older adults: a nationwide, register-based cohort study.
abstract: OBJECTIVE
  The objective of the study was to examine the association between 39 physical diseases and death by suicide in older adults.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Research Unit, Mental Health Centre Copenhagen and Faculty of Health Sciences, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark. Annette.erlangsen@regionh.dk.|Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA. Annette.erlangsen@regionh.dk.
authors.forename: Annette
authors.initials: A
authors.lastname: Erlangsen
authors.affiliation: Institute of Regional Health Service, University of Southern Denmark, Odense, Denmark.|The Mental Health Research Unit, Aabenraa, Denmark.
authors.forename: Elsebeth
authors.initials: E
authors.lastname: Stenager
authors.affiliation: Department of Psychiatry, and Office for Aging, Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Yeates
authors.initials: Y
authors.lastname: Conwell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D012042:Registries; D018570:Risk Assessment; D013405:Suicide / Q000706:statistics & numerical data*
keywords: Aged; Aged, 80 and Over; Chronic Illness; Disease; Physical disease; Suicide
references.citation: JAMA. 1997 Oct 8;278(14):1186-90
references.pmid: 9326481
references.citation: Arch Intern Med. 2004 Jun 14;164(11):1179-84
references.pmid: 15197042
references.citation: J Neurol Neurosurg Psychiatry. 1992 Jul;55(7):542-5
references.pmid: 1640228
references.citation: Am J Geriatr Psychiatry. 2002 Jul-Aug;10(4):398-406
references.pmid: 12095899
references.citation: BMJ. 1998 Apr 18;316(7139):1206
references.pmid: 9583928
references.citation: Scand J Public Health. 2011 Jul;39(7 Suppl):54-7
references.pmid: 21775352
references.citation: Psychiatr Clin North Am. 2008 Jun;31(2):333-56
references.pmid: 18439452
references.citation: Suicide Life Threat Behav. 2010 Dec;40(6):597-608
references.pmid: 21198328
references.citation: Scand J Public Health. 2011 Jul;39(7 Suppl):34-7
references.pmid: 21775348
references.citation: Medicine (Baltimore). 1994 Nov;73(6):281-96
references.pmid: 7984079
references.citation: Epidemiology. 2000 Jul;11(4):434-9
references.pmid: 10874551
references.citation: J Clin Oncol. 2008 Oct 10;26(29):4720-4
references.pmid: 18695256
references.citation: Am J Psychiatry. 2010 Feb;167(2):143-50
references.pmid: 20008942
references.citation: Int J Geriatr Psychiatry. 2010 Apr;25(4):371-9
references.pmid: 19582758
references.citation: Br J Psychiatry. 2005 Jul;187:43-8
references.pmid: 15994570
references.citation: BMJ. 2000 Nov 18;321(7271):1290
references.pmid: 11185760
references.citation: Lancet Neurol. 2007 Aug;6(8):693-8
references.pmid: 17611160
references.citation: J Psychosom Res. 2012 Dec;73(6):411-7
references.pmid: 23148807
references.citation: Arch Intern Med. 2005 Jun 13;165(11):1260-6
references.pmid: 15956005
references.citation: Aging Ment Health. 2011 Mar;15(2):214-20
references.pmid: 20967639
references.citation: BMJ. 2002 Jun 8;324(7350):1355
references.pmid: 12052799
references.citation: J Gerontol B Psychol Sci Soc Sci. 2003 Sep;58(5):S314-22
references.pmid: 14507942
references.citation: Lancet. 2009 Oct 3;374(9696):1196-208
references.pmid: 19801098
references.citation: Circulation. 2010 Dec 7;122(23):2388-93
references.pmid: 21098443
references.citation: Int J Geriatr Psychiatry. 2014 Aug;29(8):846-51
references.pmid: 25191687
references.citation: Acta Psychiatr Scand. 1994 Jul;90(1):70-2
references.pmid: 7976453
references.citation: Am J Geriatr Psychiatry. 2006 Sep;14(9):734-41
references.pmid: 16943170
references.citation: Alcohol Alcohol. 2003 May-Jun;38(3):249-54
references.pmid: 12711660
references.citation: Inflamm Bowel Dis. 2010 Dec;16(12):2158-61
references.pmid: 20848460
references.citation: Crisis. 2014;35(6):365-7
references.pmid: 25416294
references.citation: Am J Psychiatry. 1999 Feb;156(2):181-9
references.pmid: 9989552
references.citation: J Epidemiol Community Health. 2012 Mar;66(3):247-53
references.pmid: 20947873
references.citation: J Neurol Neurosurg Psychiatry. 2005 Oct;76(10):1457-9
references.pmid: 16170097
references.citation: Int Psychogeriatr. 2009 Oct;21(5):903-12
references.pmid: 19519985
references.citation: J Am Geriatr Soc. 2010 Nov;58(11):2160-5
references.pmid: 21054298
references.citation: Lancet. 2009 Apr 18;373(9672):1372-81
references.pmid: 19376453
references.citation: Br J Cancer. 2005 Mar 28;92(6):995-1000
references.pmid: 15756279
references.citation: J Epidemiol Community Health. 2001 Dec;55(12):863-6
references.pmid: 11707478
references.citation: Scand J Public Health. 2011 Jul;39(7 Suppl):26-9
references.pmid: 21775346
references.citation: J Natl Cancer Inst. 2006 Oct 4;98(19):1416-9
references.pmid: 17018788
references.citation: Crisis. 2011;32(2):106-9
references.pmid: 21616757
references.citation: J Gerontol A Biol Sci Med Sci. 2003 Mar;58(3):249-65
references.pmid: 12634292
references.citation: Arch Gen Psychiatry. 2012 Mar;69(3):256-64
references.pmid: 22393218
references.citation: Am J Geriatr Psychiatry. 2005 Mar;13(3):195-201
references.pmid: 15728750
references.citation: J Am Geriatr Soc. 2005 May;53(5):771-6
references.pmid: 15877551
references.citation: Am J Orthopsychiatry. 2007 Jan;77(1):56-60
references.pmid: 17352585
references.citation: Aging Clin Exp Res. 2002 Apr;14(2):72-93
references.pmid: 12092789
references.citation: Aging Ment Health. 2010 Nov;14(8):938-46
references.pmid: 21069599
references.citation: J Intern Med. 2013 Jan;273(1):48-58
references.pmid: 22775487
references.citation: Am J Geriatr Psychiatry. 2008 Mar;16(3):220-8
references.pmid: 18310552
references.citation: Dan Med Bull. 2007 Nov;54(4):306-69
references.pmid: 18208680
references.citation: Crisis. 2011;32(2):88-98
references.pmid: 21602163
references.citation: Am J Public Health. 1997 Mar;87(3):434-7
references.pmid: 9096548
references.citation: J Epidemiol Community Health. 2008 Feb;62(2):138-46
references.pmid: 18192602