School of Social Work, University of Texas at Austin, Austin, TX.
School of Social Work, University of Texas at Austin, Austin, TX.
Am J Geriatr Psychiatry. 2017 Dec;25(12):1404-1414. doi: 10.1016/j.jagp.2017.06.001. Epub 2017 Jul 6.
To examine 1) temporal trends between 2005 and 2014 in the three most frequently used suicide means (firearms, hanging/suffocation, alcohol/drug/medicine overdose) by decedents aged 50+ years and 2) associations of suicide means with sociodemographic and precipitating factors.
The National Violent Death Reporting System, 2005-2014, provided data (N = 46,857). Suicide means were identified from ICD-10 codes for underlying cause of death and coroner/medical examiner (CME) reports. Precipitating factors are based on either CME or law enforcement report. Age-group (50-64 and 65+ years) and gender-separate logistic regression analyses were used to examine study questions.
In the 50-64 years age group, each advancing year (i.e., from 2005 to 2014) was associated with a 1% decrease in the odds of firearm use and a 6% increase in the odds of hanging/suffocation among men; a 9% increase in the odds of hanging/suffocation among women; and a 4% decrease in the odds of overdose among each gender. In the 65+ years age group, each advancing year was associated with a 4% increase in the odds of overdose among men. Physical health was a significant factor for firearm use among men (adjusted odds ratio: 1.47; 95% CI: 1.39-1.55) only. Regardless of gender and age, mental health and substance abuse problems and prior suicide attempts were associated with hanging/suffocation and overdose.
Firearm use decreased among men aged 50-64 years between 2005 and 2014, but its use did not change among the other gender by age groups. With rapidly growing numbers of older adults, routine suicide risk assessments, firearm safety monitoring, and interventions to improve quality of life are needed.
研究 2005 年至 2014 年间，50 岁以上人群中使用最频繁的三种自杀手段（枪支、上吊/窒息、酒精/药物/药物过量）的时间趋势，并分析自杀手段与社会人口学和诱发因素的关联。
国家暴力死亡报告系统（National Violent Death Reporting System，NVDRS）2005-2014 年的数据（N=46857）提供了相关资料。通过 ICD-10 代码确定了死亡原因和法医报告中的自杀手段。诱发因素则基于法医或执法报告。对年龄组（50-64 岁和 65 岁以上）和性别分别进行逻辑回归分析，以检验研究问题。
在 50-64 岁年龄组中，每增加一年（即从 2005 年到 2014 年），男性使用枪支的几率降低 1%，上吊/窒息的几率增加 6%；女性上吊/窒息的几率增加 9%；男女使用药物过量的几率分别降低 4%。在 65 岁以上年龄组中，每增加一年，男性使用药物过量的几率增加 4%。身体健康是男性使用枪支的一个重要因素（调整后的优势比：1.47；95%置信区间：1.39-1.55）。无论性别和年龄如何，心理健康和物质滥用问题以及既往自杀企图与上吊/窒息和药物过量有关。
2005 年至 2014 年间，50-64 岁男性使用枪支的比例有所下降，但其他年龄组的男性使用枪支的比例没有变化。随着老年人口数量的迅速增加，需要进行常规的自杀风险评估、枪支安全监测以及改善生活质量的干预措施。
