Bertuccio Paola, Mosconi Giansanto, Amerio Andrea, Grande Enrico, La Vecchia Carlo, Costanza Alessandra, Vigezzi Giacomo Pietro, Aguglia Andrea, Berardelli Isabella, Serafini Gianluca, Amore Mario, Pompili Maurizio, Odone Anna
Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.
EClinicalMedicine. 2025 May 2;83:103230. doi: 10.1016/j.eclinm.2025.103230. eCollection 2025 May.
Suicide is a major and largely preventable public health issue, with rates increasing among people in later life. We aimed to describe global temporal and geographical patterns of suicide mortality among older adults.
Using the WHO mortality database (latest update: February 2024), we analysed suicide data for individuals aged 75 or older from 1990 to 2022. We selected countries based data availability, completeness, and number of suicide deaths. We computed annual age-standardised suicide mortality rates (ASR) by sex and country, and performed joinpoint regression analyses on a subgroup of major countries and geographical areas.
We considered suicide data at age 75+ from 48 countries, the EU (27 Member States) and seven geographical areas, and analysed trends in a subgroup of 20 major countries and the areas. Late-life suicide patterns differed across countries, with rates 3-7 times higher among males than females. Several countries showed steady declines by -2% to -6% annually, while in other countries like Germany, Italy, the Netherlands, the UK and Australia (males), trends slowed or stopped declining after around 2010. Increases were observed in the USA, Brazil (females), and Australia (females). Among males, the most recent highest ASR was 50.9/100,000 (95% CI: 48.1-53.7) in Centre-East Europe, while the lowest one was 12.8/100,000 (95% CI: 11.9-13.7) in North Europe. The male ASR in the EU-27 was 38.9/100,000 (95% CI: 38.0-39.9). Country-specific ASRs ranged from 10.4/100,000 (95% CI: 9.1-11.7) in the UK to 99.3/100,000 (95% CI: 93.3-104.8) in South Korea. Among females, the highest ASR was 14.4/100,000 (95% CI: 13.8-15.1) in Asia and Oceania while the lowest one was 2.4/100,000 (95% CI: 2.1-2.7) in Centre-South America. The EU-27 female rate was 8.1/100,000 (95% CI: 7.7-8.5). Country-specific ASRs ranged from less than 1 death per 100,000 in Mexico to 29.0/100,000 (95% CI: 26.8-31.3) in South Korea.
Suicide mortality shows substantial variations in rates and trends worldwide. However, data are subject to variable misclassification and underreporting in different countries and geographic areas, and therefore require cautious interpretation.
Ministry of University and Research - Decree No. 1159 of July 23, 2023 - PROBEN call.
自杀是一个重大且在很大程度上可预防的公共卫生问题，老年人的自杀率正在上升。我们旨在描述全球老年人自杀死亡率的时间和地理模式。
利用世界卫生组织死亡率数据库（最新更新时间：2024年2月），我们分析了1990年至2022年75岁及以上人群的自杀数据。我们根据数据的可用性、完整性和自杀死亡人数选择国家。我们计算了按性别和国家划分的年度年龄标准化自杀死亡率（ASR），并对主要国家和地理区域的一个子组进行了连接点回归分析。
我们考虑了48个国家、欧盟（27个成员国）和七个地理区域75岁及以上人群的自杀数据，并分析了20个主要国家和地区子组的趋势。各国晚年自杀模式各不相同，男性自杀率比女性高3至7倍。几个国家每年以-2%至-6%的速度稳步下降，而在德国、意大利、荷兰、英国和澳大利亚（男性）等其他国家，2010年左右趋势放缓或停止下降。在美国、巴西（女性）和澳大利亚（女性）观察到自杀率上升。在男性中最近最高的年龄标准化自杀死亡率是中东欧的50.9/10万（95%可信区间：48.1-53.7），而最低的是北欧的12.8/10万（95%可信区间：11.9-13.7）。欧盟27国男性年龄标准化自杀死亡率为38.9/10万（95%可信区间：38.0-39.9）。各国特定的年龄标准化自杀死亡率从英国的10.4/10万（95%可信区间：9.1-11.7）到韩国的99.3/10万（95%可信区间：93.3-104.8）不等。在女性中，亚洲和大洋洲最高的年龄标准化自杀死亡率是14.4/10万（95%可信区间：13.8-15.1），而中南美洲最低的是2.4/10万（95%可信区间：2.1-2.7）。欧盟27国女性自杀率为8.1/10万（95%可信区间：7.7-8.5）。各国特定的年龄标准化自杀死亡率从墨西哥每10万人中不到1例死亡到韩国的29.0/10万（95%可信区间：26.8-31.3）不等。
自杀死亡率在全球范围内的发生率和趋势存在很大差异。然而，不同国家和地理区域的数据存在不同程度的错误分类和报告不足，因此需要谨慎解读。
大学和研究部——2023年7月23日第1159号法令——PROBEN呼吁。
