Toronto Star

Friday, August 20, 1999

Suicides among elderly men epidemic: MDs

Doctors say society ignoring treatable problem

By Tanya Talaga
Toronto Star Medical Reporter

Suicide among elderly men is an epidemic society has ignored, doctors warn.

Older men take their own lives four to six times the rate of women, according to figures compiled by the International Psychogeriatric Association and the World Health Organization.

With aging baby boomers the quickest growing segment of the world's population, the association says people need to pay more attention to the high rates of geriatric suicide.

Depression, loneliness and declining physical abilities are some probable causes, said Dr. Eric Caine, chair of the department of psychiatry at the University of Rochester Medical Center in New York.

The ultimate tragedy is that the elderly suffer from ``eminently treatable late-onset depression,'' Caine said from the association's annual general meeting in Vancouver.

The fundamental causes of elderly male suicide are very complex at this point, he said.

Depression is not a sufficient explanation. Other factors such as lack of social support, religious beliefs and access to lethal means may also play roles, he said.

Dr. Joel Sadavoy, psychiatrist-in-chief at Mount Sinai Hospital and conference chair, said depression is identified by the World Health Organization as one of ``the leading causes of morbidity.

``The elderly are a particularly high risk for the suffering and disability of depression,'' he said.

The ninth biennial conference had drawn close to 2,000 of the world's leading scientists and mental health professionals.

Almost 75 per cent of elder suicides involve depression and fully two-thirds of those would have been late-onset and ``very treatable,'' said Caine.

The suicide rates vary across the globe and between the genders.

According to World Health Organization figures collected in 1995, Hungary has one of the highest suicide rates for men over 75, at 168.9 per 100,000. The Hungarian female suicide rate was 60 per 100,000.

Rural mainland China's suicide rate for both elderly males and females was also inexplicably high, Caine said, at 142.6 for men and 100.8 for women.

In Canada the rate for men over 75 is 26.6, and for women 3.7.

However, there is a striking difference in the United States, where the elderly male suicide rate is 50.7 and the female rate 5.6.

Elder suicide rates have been well known and documented in the medical community for years, said Dr. Molyn Leszcz of Mount Sinai and the Baycrest Geriatric Centre.

``We know people are more likely to commit suicide if they are isolated, if there is a problem with alcohol abuse and there is a physical illness that causes pain,'' he said. ``All are high risk factors.''

Elderly men's lack of social integration also hurts, he said. ``Men are more vulnerable than women, especially as they become widowed.''

Families grow up, children move away and start their own families and they often can't find time to spend with the elderly.

``We live in a society that undervalues the elderly,'' Leszcz said. ``We often don't have time for our best friends, let alone our elderly parents.''

Oddly, most elderly people who do commit suicide have ``made some kind of medical contact in the short while before their death,'' he said.

Society and the medical profession need to be more aggressive in identifying and treating depression, and being less willing to chalk behaviour up to the natural state of old age, Leszcz said.

The field of elderly suicide is one that is often neglected, said Caine. ``If you think about suicide, everybody pays attention to the youth,'' he said.

Youth suicide rates often get more attention due to the horror of young people killing themselves before their adult lives begin, Caine said.

In Canada, the youth figures are daunting. According to the Canadian Mental Health Association, the suicide rate for 15- to 19-year-olds increased by more than 600 per cent since the 1950s.

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