Draper Brian, Wand Anne P F
Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney.
Eastern Suburbs Older Persons Mental Health Service, Randwick.
Curr Opin Psychiatry. 2025 Sep 1;38(5):383-388. doi: 10.1097/YCO.0000000000001009. Epub 2025 Apr 10.
Depression and physical illnesses have long been recognized as risk factors for suicidal behaviour in late life. Qualitative studies have previously identified frailty as being an issue in late life suicidal behaviour, but quantitative studies have been lacking. Establishing the role frailty plays in suicidal behaviour in late life has implications for suicide prevention.
Depression and frailty are closely linked in late life, with genetic and social factors suggesting bidirectional causality. Frailty is associated with an increased risk of suicidal ideation and suicide attempts that is likely enhanced by chronicity, depression, and social factors, such as living and eating alone. In contrast, suicide is associated with lower levels of frailty.
Suicide rates peak in late life with depression a consistently identified risk factor along with numerous diverse factors that include physical health and social issues. In investigating the relationship between physical health and suicidal behaviour, frailty has been neglected until recently. Interventions that reduce or prevent frailty and associated depression, such as physical training and nutritional management interventions, might have a role in preventing suicidal behaviour. Further research is required to elucidate the different associations reported between frailty and suicidal ideation/attempts and frailty and suicide.
长期以来，抑郁症和身体疾病一直被认为是晚年自杀行为的风险因素。定性研究此前已将身体虚弱确定为晚年自杀行为中的一个问题，但缺乏定量研究。确定身体虚弱在晚年自杀行为中所起的作用对预防自杀具有重要意义。
在晚年，抑郁症和身体虚弱密切相关，遗传和社会因素表明存在双向因果关系。身体虚弱与自杀意念和自杀未遂风险增加相关，这种风险可能因慢性病、抑郁症以及独居和独自进食等社会因素而加剧。相比之下，自杀与较低程度的身体虚弱相关。
自杀率在晚年达到峰值，抑郁症一直是确定的风险因素，同时还有众多不同因素，包括身体健康和社会问题。在调查身体健康与自杀行为之间的关系时，身体虚弱直到最近才受到关注。减少或预防身体虚弱及相关抑郁症的干预措施，如体育锻炼和营养管理干预措施，可能在预防自杀行为方面发挥作用。需要进一步研究以阐明身体虚弱与自杀意念/未遂以及身体虚弱与自杀之间所报告的不同关联。
