Wishes to Die in Older People
A Quantitative Study of Prevalence and Associated Factors
Abstract
Background: Death thoughts and wishes occur frequently among older people. In different European countries estimates of 10%–20% have been found. Aims: To determine the prevalence and associated factors of death thoughts and wishes among older people in The Netherlands. Methods: In The Netherlands 1794 people (58–98 years) were interviewed in 2005/2006 (Longitudinal Aging Study Amsterdam). Results: 81.3% reported never having death thoughts/wishes; 15.3% reported having had such thoughts/wishes; 3.4% reported currently having a wish to die and/or a weakened wish to continue living. Of those with a current wish to die, 67% had depressive symptoms (vs. 32% of people with death thoughts/wishes ever and 9% of people who never had had death thoughts/wishes), and 20% suffered from a depressive disorder (vs. 5% if death thoughts/wishes ever; 0.3% if never death thoughts/wishes). In a multivariate analysis, a current wish to die was associated with having depressive symptoms, a depressive disorder, lower perceived mastery, financial problems, loneliness, small network, involuntary urine loss, being divorced, and having a speech impediment. Conclusions: Practical implications for health-care professionals are that they should be aware that in certain situations older people are more likely to develop a wish to die, and that a wish to die does not necessarily mean that someone has a depressive disorder. Nevertheless, it should serve as a trigger to investigate and to treat depression if present.
References
2000). Epidemiology and psychiatric morbidity of suicidal ideation among the elderly. Crisis, 21, 171–180.
(1979). Assessment of suicidal intention: The scale for suicidal ideation. Journal of Consulting and Clinical Psychology, 47, 343–352.
(1997). Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): Results from a community-based sample of older subjects in The Netherlands. Psychological Medicine, 27, 231–235.
(1996). Suicidal ideation among older primary care patients. Journal of the American Geriatrics Society, 44, 1205–1209.
(1990). Extending families: The social networks of parents and their children. Cambridge: Cambridge University Press.
(2006). Predicting the onset of major depressive disorder and dysthymia in older adults with subthreshold depression: A community-based study. International Journal of Geriatric Psychiatry, 21, 811–818.
(2001). On becoming depressed or anxious in late life: Similar vulnerability factors but different effects of stressful life events. British Journal of Psychiatry, 179, 426–431.
(1998). A review of loneliness: Concepts and definitions, determinants and consequences. Reviews in Clinical Gerontology, 8, 73–80.
(1985). The development of a Rasch-type loneliness scale. Applied Psychological Measurement, 9, 289–299.
(2003). Benefits and risks of pharmacotherapy for dysthymia: A systematic appraisal of the evidence. Drug Safety, 26, 55–64.
(2002). Attrition in the Longitudinal Aging Study Amsterdam: The effect of differential inclusion in side studies. Journal of Clinical Epidemiology, 55, 319–328.
(1992). Een nieuwe maatstaf voor stedelijkheid: De omgevingsadressendichtheid [
(A new measure for degree of urbanization: The address density of the surrounding area ]. Maandstatistiek van de Bevolking, 40, 14–27.2007). The spectrum of suicidal ideation in Great Britain: Comparisons across a 16–74 year age range. Psychological Medicine, 37, 795–805.
(1975). “Mini-Mental State”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.
(1997). Suicidal thoughts and associated factors in an elderly population. Acta psychiatrica Scandinavica, 95, 108–111.
(1990). Are old people more depressed? Cross-sectional data on Center for Epidemiological Studies Depression Scale factors. Psychology and Aging, 5, 284–290.
(1981). The Nottingham Health Profile: Subjective health status and medical consultations. Social science and Medicine, 15A, 221–229.
(1995). Factors associated with the wish to die in elderly people. Age Ageing, 24, 389–392.
(1997). Do disease specific characteristics add to the explanation of mobility limitations in patients with different chronic diseases? A study in The Netherlands. Journal of Epidemiology and Community Health, 51, 676–685.
(1996). Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. Journal of Clinical Epidemiology, 49, 1407–1417.
(1995). Psychosocial recovery from a cardiac event: The influence of perceived control. Heart Lung, 24, 273–280.
(1974). Suicidal feelings in the general population: A prevalence study. British Journal of Psychiatry, 124, 460–469.
(1978). The structure of coping. Journal of Health and Social Behavior, 19, 2–21.
(1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
(2002). Women recovering from acute myocardial infarction: Psychosocial and physical functioning outcomes for 12 months after acute myocardial infarction. Heart Lung, 31, 399–410.
(1997). Suicidal thinking in community residents over 80. International Journal of Geriatric Psychiatry, 12, 337–343.
(1981). National Institute of Mental Health Diagnostic Interview Schedule: Its history, characteristics and validity. Archives of General Psychiatry, 38, 381–389.
(1986). Aging and health: Effects of the sense of control. Science, 233, 1271–1276.
(2005). Requests for euthanasia or physician-assisted suicide from older persons who do not have a severe disease: An interview study. Psychological Medicine, 35, 665–671.
(1997). The Center for Epidemiological Studies-Depression (CES-D) Scale: Assessment of depression in the medically ill elderly. International Journal of Geriatric Psychiatry, 12, 436–446.
(2006). Predicting loss of mastery in older adults. Tijdschrift voor Gerontologie en Geriatrie, 37, 243–253. [In Dutch].
(2002). One-year prevalence of death thoughts, suicide ideation and behaviors in an elderly population. International Journal of Geriatric Psychiatry, 17, 842–846.
(1996). Suicidal feelings in a population of nondemented 85-year-olds. American Journal of Psychiatry, 153, 1015–1020.
(1975–1998). Cultural changes in The Netherlands. The Hague: Author.
. (2003). Drug treatment in depressed elderly in the Dutch community. International Journal of Geriatric Psychiatry, 18, 99–104.
(2008). Trends in antidepressant use in the older population: Results from the LASA-study over a period of 10 years. Journal of Affective Disorders, 111, 299–305.
(2007). Coping resources, coping processes, and mental health. Annual Review of Clinical Psychology, 3, 377–401.
(1976). A scale to measure the stress of life events. The Australian and New Zealand Journal of Psychiatry, 10, 27–32.
(1991). The self-rating of health: Methodological effects of the rating of health in health interview surveys. Maandbericht Gezondheid, 10, 15–23. [In Dutch]
(1998). Losing and gaining in old age: Changes in personal network size and social support in a four-year longitudinal study. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 53, S313–S323.
(2003). Criterion validity of the self-rating inventory for posttraumatic stress disorder (SRIP) in the community of older adults. Journal of Affective Disorders, 76, 229–235.
(2003). A prevalence study of suicide ideation among older adults in Hong Kong SAR. International Journal of Geriatric Psychiatry, 18, 1056–1062.
(1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.
(