Physical Health Crises Preceding Suicide from Late Midlife Through Older Age: Illnesses, Contexts, and Age-Group Differences.

OBJECTIVES

To examine how physical health (PH) crises preceding suicide differ from late midlife (50-64 years) to older age (≥65 years).

METHODS

Using 2022-2023 National Violent Death Reporting System-Restricted Access Data, we analyzed suicide decedents aged ≥ 50 with a PH problem as a precipitant (N = 11,796) and reviewedct 2 coroner/medical examiner and law enforcement narratives for those with a PH crisis.

RESULTS

PH crises increased with age, occurring in 3.7% of decedents aged 50-64, 8.5% aged 65-74, 12.3% aged 75-84, and 12.8% aged ≥ 85. Terminal illness and pain were principal health correlates of PH crisis status. Pain was less frequently implicated with increasing age, whereas functional limitations, heart disease, falls, and dementia were generally more prevalent in older groups. Narratives showed that crises in late midlife more often involved occupational and economic consequences, whereas those in older age involved threatened autonomy, dependence, perceived burdensomeness, and care transitions.

CONCLUSIONS

PH crises became more prominent with advancing age, while the illnesses and contexts differed from late midlife through older age.

CLINICAL IMPLICATIONS: Healthcare professionals should assess suicide risk when older adults experience serious or worsening PH problems. Suicide prevention approaches should adopt collaborative safety planning including both health services and age-appropriate care support.