Aim: Older adults have the highest suicide rates of all age groups. Suicide in this population is characterised by a high lethality of attempts and low help-seeking behaviour. Understanding risk and protective factors to suicidality can help to gain vital insights in the suicidal process and identify areas for detection and prevention. The objective of this study is to identify risk and protective factors to a wish to die in older adults in Flanders.
Methodology: Data for this study comes from the Belgian Ageing Studies (BAS) (N=88180), a cross-sectional project that has monitored the needs and quality of life of community-dwelling older adults (60+) across Flemish municipalities through a large, standardised survey since 2002. Items on suicidality were added to the survey in 2016, giving this research a representative sample of (N=3050). This study focuses on older adults reporting a current wish to die. Examples of other measures are: depression, loneliness, physical frailty and ageism. Descriptive statistics determine the prevalence and the spread of risk and protective factors. Logistic regression identifies risk and protective factors.
Results: 4.8% (N=148) of the sample (N=3050) reported having a current wish to die. Of these, a majority also reported a history of suicidal ideation and/or suicide attempts. Descriptive statistics showed people with a wish to die were more often female and older (80+), as well as widowed or divorced. Results from the logistic regression showed the following significant risk factors: a history of suicidal ideation or behaviour, depression, subjective cognitive complaints, requiring support on multiple domains and elder abuse.
Conclusion: this study is the first of its kind on this scale, in Belgium. The results show new insights, specifically on the influence of subjective cognitive complaints and the experience of elder abuse as risk factors. Furthermore, the results allude to the importance of dependency on others as a risk factor, over limitations in physical functioning, as has previously been suggested. In general, this study shows the need for nuance in the ongoing societal debate in Belgium and the Netherlands on euthanasia or assisted dying for older adults who consider their life complete, by showing that a wish to die in this population is not normative.