Mezuk Briana, Prescott Marta R, Tardiff Kenneth, Vlahov David, Galea Sandro
Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.
J Am Geriatr Soc. 2008 Nov;56(11):2107-11. doi: 10.1111/j.1532-5415.2008.01990.x.
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.
The New York City (NYC) Office of the Chief Medical Examiner (OCME).
Suicide deaths in NYC from 1990 to 2005.
Location and method of suicide death reported by OCME.
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.
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).
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.
描述长期护理（LTC）机构中老年人自杀相关特征，比较LTC机构中自杀案例与社区中自杀案例的特征，并评估过去15年这些环境下的自杀趋势。
纽约市（NYC）首席法医办公室（OCME）。
1990年至2005年纽约市的自杀死亡案例。
OCME报告的自杀死亡地点和方式。
比较LTC机构中老年人自杀案例与社区居住老年人自杀案例的人口统计学特征和所用方式。使用零膨胀泊松回归分析自杀率比（RRs）的趋势。
在研究期间，纽约市60岁及以上居民中有1771例自杀：LTC机构中有47例，社区中有1724例。LTC机构中的案例往往年龄更大（P<0.02），但在种族或性别方面与社区案例无差异。LTC机构中的自杀案例因枪支导致的可能性显著更低（RR=0.05，P<0.002），因高处坠落导致的可能性是社区案例的2.49倍（P<0.002）。在这15年期间，社区居住成年人的相对自杀率显著下降（RR=0.97，P<0.001），但LTC机构居民的自杀率无变化（RR=1.05，P<0.17）。
在过去15年中，社区居住老年人的自杀风险有所下降，但LTC机构中的自杀风险没有变化。这表明预防措施可能没有有效地覆盖到这一人群。
