Risk factors for suicide among older adults with cancer

Abstract

Objective: To determine whether the increased risk of suicide for individuals with cancer may be explained by functional limitations, lack of social support, or other factors.Method: In this population-based case-control study, interviews of primary informants for suicides in the state of North Carolina were compared to interviews with participants in the Piedmont Health Study of the Elderly to estimate adjusted odds ratios for suicide and self-reported, physician diagnosed cancer, heart attack, stroke, and hip fracture.Results: Adjusting for all other factors, there was a statistically significant association of suicide and cancer (odds ratio [OR] 2.62, 95% confidence interval [CI] CI 1.84–3.73), but not heart attack, hip fracture, or stroke. The risk of suicide was also elevated for men vs. women (OR 17.15, CI 10.88–27.02), whites vs. blacks (OR 9.70, CI 6.07–15.50), and individuals with stressful life events (OR 2.75, CI 1.97–3.86) or limitations of instrumental (OR 2.93, CI 2.03–4.22) but not physical activities of daily living. Suicide cases were not more likely to be short of breath or poor sleep quality. Suicide was statistically significantly less likely for study participants who were married with spouse living vs. other (OR 0.61, CI 0.43–0.88) or who had one or more indicators of social support (OR 0.27, CI 0.19–0.39).Conclusion: After adjustment for other risk factors, suicide was strongly associated with cancer but not with other disabling, potentially fatal conditions.

Keywords:

• suicide
• social support
• functional status
• epidemiology (mental health)
• physical disorders

Acknowledgements

The investigators would like to thank the study participants who shared their life experiences and the interviewers who empathically interviewed them for this study.

Additional information

Funding

This research was funded by a grant from the Centers for Disease Control and Prevention [grant number FOA 89027].