Life weariness, suicidal thoughts and mortality: A seventeen-year longitudinal study among men and women older than 60 years

Abstract Background Suicide in old age is a significant contributor to premature mortality. However, the extent to which life weariness and suicidal thoughts impact on mortality in a long-term perspective is still unknown. The aim of this study was to investigate the effect of life weariness and suicidal thoughts on long-term survival (17 years) in an older Swedish population (60 + years), controlling for demographic and social network factors and depression. A further aim was to investigate differences in sex and age interactions in relation to mortality among individuals with and without life weariness and suicidal thoughts. Methods A longitudinal cohort study on a national, representative sample of people 60 + years was conducted through the Swedish National Study of Aging and Care study and included n = 7,213 individuals, who provided information about life weariness and suicidal thoughts, through an item derived from the Montgomery-Åsberg Depression Rating Scale. Data were analysed with multivariate Cox proportional hazards models, adjusted for potential confounders. Results At baseline, 12.5% of the participants (14.6% of females and 9.5% of males) reported life weariness and suicidal thoughts. During the 17-year follow-up, survival time was 11.5 years, SD 5.6, and 3,804 individuals died (59.5% females and 40.5% males). Individuals with life weariness and suicidal thoughts had half the survival rate compared with those without such thoughts (24.5% vs. 50.6%), with a survival time of 8.4 years (Standard deviation, SD, 5.7) versus 12.0 years (SD 5.4). The multi-adjusted hazard ratio of mortality for reporting life weariness and suicidal thoughts was 1.44 (95% confidence interval, 1.30–1.59), the population attributable risk was 11.1%. In the models, being male or female 80 + years (ref. female 60–69 years) showed the highest multi-adjusted hazard ratio of long-term mortality. Conclusions Findings suggest that life weariness and suicidal thoughts are risk factors for long-term mortality, when controlling for sex and age interactions that were found to strongly predict long-term mortality. The findings have practical implications in prevention of premature mortality, emphasising preventive actions of screening, identifying, and intercepting older men and women with signs of life weariness and suicidal thoughts.