Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 … – BMC Public Health

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Suicide in previous age is a major contributor to mortality. Nevertheless, the extent to which life weariness and suicidal ideas affect on mortality in a long-term perspective is unknown. The intention of this examine was to research the impact of life weariness and suicidal ideas on long-term survival (16 years) in an older Swedish inhabitants, controlling for demographic and social community elements and despair. An extra intention was to research variations in intercourse and age interactions in relation to mortality amongst people with and with out life weariness and suicidal ideas.
A longitudinal cohort examine on a nationwide, consultant pattern of people aged 60+ years was carried out throughout the Swedish Nationwide Examine of Getting older and Care examine. The pattern included 7213 people, who offered details about life weariness and suicidal ideas by an merchandise derived from the Montgomery-Åsberg Despair Ranking Scale. Knowledge have been analysed with multivariate Cox proportional hazards fashions, adjusted for potential confounders.
At baseline, 12.5% of the contributors (14.6% of females and 9.5% of males) reported life weariness and suicidal ideas. Through the 16-year follow-up, a imply survival time was 11.5 years (customary deviation (SD) 5.6), and 3804 people died (59.5% females and 40.5% males). People with life weariness and suicidal ideas had half the survival charge in contrast with these with out such ideas (24.5% vs. 50.6%), with a imply survival time of 8.4 years (SD 5.7) versus 12.0 years (SD 5.4). The multi-adjusted hazard ratio of mortality for these reporting life weariness and suicidal ideas was 1.44 (95% confidence interval, 1.30–1.59), with the inhabitants attributable threat at 11.1%. Within the fashions, being male or feminine 80+ years confirmed the very best multi-adjusted hazard ratio of long-term mortality (ref. feminine 60–69 years).
The findings steered that life weariness and suicidal ideas have been threat elements for long-term mortality, when managed for intercourse and age interactions that have been discovered to strongly predict long-term mortality. These findings have sensible implications in prevention of mortality, emphasising the significance of screening, figuring out, and intercepting older women and men with indicators of life weariness and suicidal ideas.
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Suicide charges in late life are excessive in most international locations, making suicide a significant public well being concern worldwide [1,2,3]. Globally, the all-age suicide charge is 11.1 deaths per 100,000 [4]. In Sweden, the speed is even increased (15 deaths per 100,000), and differs vastly between the sexes within the age group 65–84 years (24.4 deaths per 100,000 in males and seven.3 per 100,000 in ladies) [5]. Early indicators of suicidality, comparable to suicidal ideas, have been steered as being among the many most prevalent predictors of accomplished suicide [6, 7], however little is thought relating to the long-term impact on mortality of suicidal ideas in late life.
The spectrum of suicidality ranges from life weariness and suicidal ideas to suicide makes an attempt and accomplished suicide [8, 9]. A number of ideas are used within the literature to explain preliminary or early indicators of suicidality, comparable to suicidal emotions, suicidal ideation, and suicidal ideas (see for instance [10,11,12]). On this examine, we used the time period “life weariness and suicidal ideas”, comprising suicidal features comparable to life weariness, demise needs, suicide preparation, and suicide planning [13].
To our information, there are few long-term longitudinal research which have investigated the affect of life weariness and suicidal ideas on mortality inside nationwide, consultant samples of older adults. One 5-year mortality examine from 2010 discovered that the “want to die” was related to mortality in regular care of older adults who have been major well being care sufferers (n = 1202) [14]. One other examine from 2013 introduced knowledge from 861 community-based older adults (70+), adopted throughout 17 years, and located that suicidal ideation elevated the danger of demise from pure causes by 23% [15]. For a number of causes, you will need to emphasise the potential affect of life weariness and suicidal ideas on mortality. Older adults with life weariness and suicidal ideas might threat a decline in each bodily and psychological well being by, for instance, discount of illness administration, remedy adherence, well being care visits, bodily actions, or meals consumption. It’s affordable to imagine that detection of life weariness and suicidal ideas, if it leads to applicable actions, referrals, and follow-ups, might assist forestall mortality in older adults.
On this examine, we thought-about a number of elements that could be related in explaining the danger of demise in older adults with suicidal ideas: demographic elements, social community elements, and despair. A lot of the earlier analysis relating to these elements in older adults is cross-sectional and gives a limitative snapshot of life weariness and suicidal ideas in late life. Concerning demographic and social community elements, longitudinal analysis means that age, intercourse, marital standing, schooling, monetary scenario, residing scenario, and nation of origin are considerably related to suicidal ideas (see for instance [6, 7, 10, 16, 17]). Despair has additionally been discovered to be related to suicidal ideas in older adults (see for instance [11, 18]). A complete mannequin during which a number of of those variables are concurrently accounted for can reveal whether or not particular variables exacerbate vulnerability amongst older adults with life weariness and suicidal ideas. Moreover, specializing in intercourse and age and accounting for his or her interplay might present data that will be vital to think about when creating preventive interventions focusing on the older inhabitants.
The present examine was supposed to handle a niche within the literature: the restricted analysis in nationwide, consultant samples of older adults with long-term longitudinal knowledge on the affect of life weariness and suicidal ideas on mortality. Thus, the intention of the examine was to research the impact of life weariness and suicidal ideas on long-term survival (16 years) in an older Swedish inhabitants (60+), controlling for demographic and social community elements and despair. An extra intention was to research variations in intercourse and age interactions in people with and with out life weariness and suicidal ideas.
People included on this longitudinal examine participated within the Swedish Nationwide Examine on Getting older and Care (SNAC), which was initiated in 2001 at centres in a number of elements of Sweden. The SNAC is a potential multicentre examine and contains randomly chosen people in 10 age clusters (age in years: 60, 66, 72, 78, 81, 84, 87, 90, 93, 96+), drawn from the nationwide inhabitants register. All people within the oldest age teams (i.e., 81–96+) have been invited, with an oversampling course of used because of the lowering numbers of potential contributors. Extra details about the SNAC examine might be learn elsewhere [19].
At baseline, throughout the interval 2001–2004, contributors (n = 7418) have been recruited from geographical areas overlaying a medium-sized city, small cities, rural areas (5 municipalities within the Skåne area and one municipality in Blekinge, all positioned in southern Sweden), and one city district in Sweden’s capital, Stockholm. The contributors have been invited to the mission by publish and causes for non-participation have been registered. For the current examine, these contributors who gave details about life weariness/suicidal ideas at baseline have been included (n = 7213) and adopted for as much as 16 years. The follow-up interval started on the time of every particular person’s baseline examination and ended after 16.4 years (i.e., 6000 days) or at time of demise.
The examine was carried out in accordance with the moral ideas of the Helsinki Declaration and each verbal consent and written knowledgeable consent have been obtained. The SNAC examine was accredited by the Ethics overview boards of Lund College, LU 128 00, LU 650–00, LU 744–00 and Karolinska Institutet, Dnr 01–114.
The info assortment group included educated nurses, physicians, and check leaders. Members who couldn’t come to the analysis centres have been provided house visits in an effort to keep away from choice bias. Knowledge on participant age, intercourse, schooling, residing preparations, marital standing, geographical residence, monetary scenario (two gadgets), nation of beginning, self-reported despair (one merchandise), social help (three gadgets), and spiritual beliefs have been obtained by single-item self-administered questionnaires (see Desk 1 for particulars relating to gadgets and response choices).
Details about the people’ present ideas on life weariness and suicide was collected within the questionnaire and measured by one of many 9 gadgets (merchandise 9) derived from the Montgomery-Åsberg Despair Ranking Scale (MADRS). The unique response alternate options vary from 0 to six: 0 = Enjoys life or takes it because it comes; 2 = Weary of life. Fleeting suicidal ideas; 4 = Most likely higher off useless. Suicidal ideas are frequent. Suicide is taken into account a doable answer, however with out particular plans or intention; 6 = Specific plans for suicide. Lively preparation for suicide [13]. Extra details about the MADRS scale and in what method the merchandise was used within the older inhabitants might be learn elsewhere [12]. Within the current examine, suicidal expressions, together with life weariness and suicidal ideas, have been labeled into the next classes: (0) no life weariness or suicidal ideas, [1, 2] life weariness, and [3,4,5,6] suicidal ideas. The end result variable of survival, i.e., date of demise, was collected from the Swedish Nationwide Dying Register.
Descriptive statistics have been used for variables in demographic knowledge, comparable to social help, despair, and life weariness and suicidal ideas, and given as absolute values and percentages (%). Chi-squared exams, the Mann-Whitney U-test, and the Scholar’s t-test have been used to check the variations within the proportions at a nominal, ordinal, and interval knowledge degree, respectively. Members have been divided into three age teams (60–69, 70–79, and 80+ years) and age was mixed with intercourse in an interplay variable. Survival time was calculated from the date of the baseline survey to the date of demise throughout the 16-year follow-up, with time intervals introduced in days: 0, 2000, 4000, and 6000 days, corresponding to five.5, 11 and 16.4 years. To estimate the affect of the interplay of age and intercourse on survival, a Kaplan-Meier survival evaluation was carried out (for age group (60–69, 70–79, or 80+) and intercourse together) in the entire pattern, and in these with and with out life weariness and suicidal ideas individually.
The variations between teams relating to mortality, sex-age interplay, and presence or absence of life weariness and suicidal ideas, have been examined and assessed utilizing the log-rank check. To discover life weariness and suicidal ideas along with the impartial threat elements of mortality, the variables that confirmed a major affiliation in univariate evaluation (sex-age interplay, marital standing, schooling, housing, geographic space, feeling lonely, help from others, social contacts, and suicidal ideas) have been entered concurrently right into a multivariate Cox proportional hazard mannequin (enter mannequin). The confounders, nation of beginning, despair, and monetary assets have been included within the mannequin as effectively. To confirm the proportional hazard assumption, the cumulative hazard operate was inspected visually. Fashions together with adjusted variables have been additionally created for people with and with out life weariness and suicidal ideas individually. Earlier than getting into the variables sex-age interplay, marital standing, geographic space, nation of beginning, and social contacts, dummy variables have been used to tell apart between completely different teams. The chance ratio significance check was used to evaluate goodness-of-fit for the fashions created. Cox proportional hazard fashions have been used to calculate the multi-adjusted hazard ratio (HR) with 95% confidence interval (CI) of mortality in a long-term perspective, with a selected concentrate on life weariness and suicidal ideas on the baseline examination. The inhabitants attributable threat (PAR) of life weariness and suicidal ideas was calculated with HR [20]. SPSS 25.0 (IBM SPSS Statistics for Home windows, Model 25.0. Armonk, NY: IBM Corp., USA) was utilized in all analyses, and the extent of significance was set to p <  0.05.
At baseline, the examine pattern included 7213 contributors (59.5% females), with a imply age of 73.11 years (SD 10.72). A complete of 3804 (52.7%) people died throughout the statement interval. The 80+ females had the very best proportion of deaths (38.1%), twice as excessive because the 80+ males (18.5%). In contrast with the people within the deceased group, the survivors differed considerably in all variables included, besides within the variable of monetary difficulties over the past yr.
Within the whole pattern, 12.5% of the people reported life weariness and suicidal ideas at baseline. Fewer people within the survival group reported life weariness and suicidal ideas in contrast with these within the deceased group (6.5% vs. 17.9%). At baseline, extra females and males within the oldest age group (80+) had life weariness and suicidal ideas (23.0 and 17.9%, respectively) than females and males within the youngest age group (60–69) (8.1 and 4.9%, respectively) (P <  0.001). Demographic traits of the survivors and the deceased are proven in Desk 1.
People with life weariness and suicidal ideas had half the survival charge (24.5% vs. 50.6%) of these with out such ideas, with a survival time of 8.4 years (SD 5.7) versus 12.0 years (SD 5.4). The six teams of sex-and age interactions differed considerably in survival charge within the whole pattern and in people with and with out life weariness and suicidal ideas, respectively (log-rank check P <  0.001). Within the group of people with no life weariness and suicidal ideas, males within the age group 80+ confirmed the bottom survival charge (6.4%) and survival time (imply 6.6 years, SD 4.5) compared with any of the combos feminine 80+ years (8.7%, imply 7.4 years, SD 4.7), male 70–79 years (32.6%, imply 10.9 years, SD 5.2), feminine 70–79 years (49.6%, imply 12.6 years, SD 4.8), male 60–69 years (77.0%, imply 14.6 years, SD 4.0), or feminine 60–69 years (85.0%, imply 15.4 years, SD 3.1). Within the group of people with life weariness and suicidal ideas, males 80+ years additionally confirmed the bottom survival charge and survival time (0%, imply 4.5 years SD 3.2) in contrast with females 80+ years (4.4%, imply 6.0 years, SD 4.2), males 70–79 years (11.0%, imply 7.3 years, SD 5.0), females 70–79 years (33.6%, imply 10.4 years, SD 5.5), males 60–69 years (66.7%, imply 13.4 years, SD 5.2), or females 60–69 years (77.6%, imply 14.9 years, SD 3.7). Separate survival curves for sex-age interactions in people within the whole pattern and in these with or with out life weariness and suicidal ideas at baseline, respectively, and numbers of individuals grouped by threat exposures, are introduced in Figs. 1, 2 and 3.
Survival curves and life 18 desk, for the overall pattern (log rank check, p worth < 0.001)
Survival curves and life desk, for these with no life weariness and suicidal ideas (log rank check, p worth < 0.001)
Survival curves and life desk, for these with life weariness/suicidal ideas (log rank check, p worth < 0.001)
The outcomes from the Cox proportional hazard fashions (univariate and multivariate) confirmed important associations between life weariness and suicidal ideas and survival time. Within the univariate Cox proportional hazard mannequin, the HR of mortality was 1.42 (95% CI 1.31–1.55, P <  0.001) for many who reported life weariness and suicidal ideas and the HR of mortality remained when adjusting for the management elements included. The multi-adjusted HR of mortality for many who reported life weariness and suicidal ideas was 1.44, 95% CI 1.30–1.59 (P <  0.001) (Desk 2). PAR was 11.1%, the place these with life weariness and suicidal ideas had a decrease survival charge and shorter survival time (log-rank check, P <  0.001). Women and men 80+ years (ref. feminine 60–69 years) had the very best multi-adjusted HRs of mortality: 17.79 and 11.21, respectively (95% CIs 15.13–20.90 and 9.60–13.08, respectively). The HRs of the sex-age interactions (female and male 80+ years) in relation to mortality remained excessive within the stratified hazard fashions for all times weariness and suicidal ideas, particularly in people with life weariness and suicidal ideas at baseline (HR males 22.39, CI 13.85–36.18; HR females 12.49, CI 7.93–19.66) (Desk 3). Determine 4 reveals the survival curves for people with and with out life weariness and suicidal ideas, adjusted for the management elements included (demographic elements, social community elements, and despair).
Survival curves for all times weariness and suicidal ideas, adjusted for management elements. Observe: The time intervals are introduced in days: 0, 2000, 4000, and 6000 days, corresponding to five.5, 11 and 16.4 years
This examine, primarily based on a big, geographically various, nationwide pattern of an older inhabitants, investigated the impact of life weariness and suicidal ideas on mortality when controlling for anticipated age-related elements. A complete of 12.5% of contributors reported life weariness and suicidal ideas at baseline. About half of the people had died on the finish of the examine and interplay of intercourse and better age elevated the danger of demise. Our evaluation has added worth regarding our understanding of the impact of life weariness and suicidal ideas on mortality in older adults. For instance, being a person with life weariness and suicidal ideas was independently related to a 1.44 instances increased threat (hazard ratio) of demise inside 16 years, compared with these with out such ideas. People with life weariness and suicidal ideas had a shorter imply survival time (3.6 years) and their survival charge was half that of different people (24.5% vs. 50.6%).
Older adults have beforehand been discovered to be significantly susceptible to well being issues on account of diminished inside and exterior assets [21], elements included within the current examine. Diminished assets enhance the complexity of assembly, figuring out, treating, and finding out older people relating to suicidality. The excessive mortality charge discovered on this examine underscores the significance of detecting life weariness and suicidal ideas in older individuals. Moreover, the findings point out that delicate and early indicators of suicidality, comparable to life weariness and suicidal ideas, should be assessed extra structurally and completely in previous age, particularly inside group and first care settings. By detecting life weariness and suicidal ideas by screening, figuring out causes, and creating options, we might enhance preventive methods and remedy, and thereby scale back the danger of mortality.
With the anticipated enhance of life weariness and suicidal ideas within the inhabitants on account of elevated demographic getting old, it’s vital to grasp early indicators and threat elements for mortality. The current examine contributes to the understanding of the doable long-term affect of demographic and social elements on mortality in older adults. Our examine is supported by earlier proof on the elevated threat of demise in older adults with suicidal ideas [14, 15]. A latest Korean literature overview identified that multi-level elements, together with particular person, household, and social features, can work together over a lifetime to guard towards suicidal ideas in older adults [22]. This highlights the significance of together with a number of elements over time in analysis. Nevertheless, there are nonetheless few strong research from different international locations and beneath different situations, making it tough to validate outcomes.
Concerning the demographic elements, the current examine confirmed a number of features of the intercourse and age interplay with suicidality established by earlier analysis, most of which was cross-sectional. On this examine, extra females (8%) than males (3.7%) had life weariness and suicidal ideas at baseline (P <  0.001). The very best proportion of life weariness and suicidal ideas was discovered within the group of females 80+ years (23.0%), adopted by males in the identical age group (17.9%). The outcomes relating to intercourse are supported by Barnow et al. [23] and Barnow and Linden [1], however not by Almeida et al. [24] and Ko et al. [25], who discovered the next proportion amongst males. Apparently, when investigating the predictive worth of the sex-age interplay for mortality, we discovered that males, not females, 80+ years with life weariness and suicidal ideas, had the very best multi-adjusted hazard ratio of mortality (22.4, CI 13.85–36.18). In earlier literature, there isn’t any clear consensus on if the intercourse of older adults has a possible relationship with suicidality. As an illustration, it has been discovered that older males are at increased threat of suicide than females [3, 24, 26,27,28,29], whereas females report extra suicidal ideas in comparison with males [1, 23, 30, 31] but additionally that there are not any intercourse variations as regards suicidal ideas [12]. Right here, the various outcomes could also be on account of the usage of completely different spectrums of the idea, the contexts, and the measurements of suicidality within the research of older populations, in addition to variations within the ages of the populations included. This complexity justifies the idea of moderation by a number of elements, and confirms the relevance of together with socio-demographic knowledge to confirm elements contributing to mortality.
One other vital discovering of the current examine was that life weariness and suicidal ideas elevated with increased age. This discovering is in settlement with prior analysis displaying that suicidal ideas enhance in older adults [10]. As well as, the very best distinction in survival charge was present in males 70–79 years, the place these with out life weariness and suicidal ideas had 3.6 years longer imply survival time (10.9 years vs. 7.3 years, P worth < 0.001) than these with life weariness and suicidal ideas. We didn’t particularly examine the danger of demise by accomplished suicide, which is increased in older males, however our examine signifies that being a male, particularly of excessive age, with suicidal ideas, elevated the danger of demise. It needs to be famous that our examine, like earlier analysis, requested solely about authorized intercourse (i.e., male or feminine) and we lack an understanding of how gender identification probably impacts the outcomes introduced right here.
A number of different impartial predictors, other than life weariness, suicidal ideas and sex-age interactions, had various but important significance for mortality within the fashions separated for people with and with out life weariness and suicidal ideas (cf. Desk 3). Residing in a residential care facility, being born in a rustic exterior Europe, not being married, having inadequate monetary assets, having low schooling, and having an inadequate social community must also be thought-about within the dialogue of mortality and life weariness and suicidal ideas in older adults. Though not investigated right here, it will not be residing in a residential care facility that will increase the danger of demise, however declined bodily and psychological well being and useful capability and a scarcity of social relationships. The latter are extra frequent in individuals residing in residential care amenities than in these residing in peculiar houses. Holt-Lunstad et al. [32] and Yasuda et al. [33] additionally noticed the significance of social community contacts for mortality, however discovered that contacts decreased with age. The variety of those who an individual feels they’ll belief has additionally, in earlier literature, been related to mortality in previous age [34, 35]. In Sweden, about half of these within the older inhabitants (80+) reside alone [36]. Moreover, within the age group 80+, extra ladies than males reside alone and about 80% of them are widows [37], who typically have restricted monetary assets and low schooling, i.e., elements linked to mortality in previous age [38]. Such circumstances should be thought-about when striving to grasp variations in survival in older adults, in addition to the various significance of those elements within the teams with and with out life weariness and suicidal ideas.
Within the literature, there are conflicting outcomes relating to whether or not the impact of suicidal ideas on mortality in older adults stays after controlling for elements comparable to despair [15]. The findings within the current examine counsel that life weariness and suicidal ideas affect mortality in previous age, after controlling for despair. That is according to two different longitudinal research which discovered that suicidal ideas had a major affiliation with mortality after controlling for numerous elements, together with despair [14, 15]. This discovering has vital implications for focused preventive actions in previous age psychological well being to lower mortality. A scientific literature overview specializing in preventive interventions for suicidal ideas in older adults discovered that almost all research have focused despair as a threat issue, for instance by major care despair screening and administration [39]. Such interventions are vital, however will not be enough to stop suicidal ideas and mortality in the long run. Moreover, earlier analysis has discovered despair to be a powerful influential issue for suicidality in previous age (see for instance [24, 28, 40]). Dying by suicide was not investigated within the current examine, but our outcomes confirmed that despair had an impact on mortality within the case of people reporting life weariness and suicidal ideas. The results of life weariness, suicidal ideas, and despair on mortality are undoubtedly complicated, with issue figuring out the potential reverse results of mortality on despair and suicidal ideas. Nonetheless, contemplating the elevated threat of demise in people with life weariness and suicidal ideas and with out despair within the current examine, extra analysis into preventive interventions is required.
The strengths of this examine included the possible design, with the chance to research the long-term results on mortality in a big pattern, and the nationally consultant pattern. The examine additionally included a number of demographic and social confounders that are related in superior age and might be anticipated to affect the affiliation between suicidal ideas and mortality. Moreover, the pattern included people from each city and rural areas, and from each peculiar houses and residential care amenities, which means that the end result might be mentioned and generalised to a bigger old-age inhabitants. Limitations would possibly embrace that we had no details about the people who participated at baseline however have been misplaced on the time of the follow-up. Additionally, the usage of self-reported life weariness and suicidal ideas may need launched a bias by underreporting, on account of normalisation and non-recognition [3] of the signs in late life. This will have led to a misclassification of the danger group. Furthermore, though the merchandise taken from the MADRS scale contains response choices starting from life weariness to specific plans and lively preparation for suicide, the unique merchandise used is described solely as suicidal ideas by the authors [13], which could possibly be deceptive within the conceptualisation of the idea (cf. 12). Moreover, the rankings in MADRS have been primarily based on the people’ present ideas of life weariness and suicidal ideas, which means that the timepoint may need been unsure.
Among the many people randomly invited to take part in SNAC, the commonest purpose to not take part was poor well being. It could be a limitation that solely despair was included within the evaluation as a widely known predictor of suicidal ideas. Moreover, the details about despair was self-reported and never verified by analysis. There may be purpose to imagine that ailments aside from despair could have a relationship with life weariness and suicidal ideas and can be related to incorporate, particularly contemplating that the variable residential house facility was an impartial threat issue for mortality. Nevertheless, the potential significance of well being elements was exterior the scope of the current examine. Roughly 3% (n = 203) of the included people declined to share details about life weariness and suicidal ideas, which means that the speed of people with life weariness and suicidal ideas could possibly be underrepresented. Nevertheless, the proportion discovered (12.5%) replicated earlier findings of suicidal expressions, the place about 13% skilled life weariness [41]. This examine didn’t intention to research particular causes of demise and additional analysis are wanted to grasp the causal mechanism between suicidality and survival.
This examine is, to our information, the primary to research the connection between life weariness and suicidal ideas and survival in older adults, utilizing a big and nationally consultant pattern over a very long time interval. The findings underlined life weariness and suicidal ideas as threat elements for long-term mortality. People with life weariness and suicidal ideas had half the survival charge and a shorter survival time in contrast with these with out such ideas. This examine additionally confirmed that the interplay between intercourse and age predicted long-term mortality amongst older adults, particularly in people with life weariness and suicidal ideas. The findings counsel that screening, figuring out, and intercepting early indicators of suicidality in older adults with life weariness and suicidal ideas might enhance the survival charge within the older inhabitants.
The general public entry to the database SNAC is closed. We’ve obtained administrative permission to entry and use knowledge in SNAC from the Major Investigators (PI) of the three cites included (SNAC Blekinge, GÅS and Kungsholmen). All knowledge generated or analysed throughout this examine are included on this revealed article.
confidence interval
Good Getting older in Skåne
hazard ratio
chance ratio
Montgomery-Åsberg Despair Ranking Scale
the inhabitants attributable threat
customary deviation
Swedish Nationwide Examine on Getting older Care
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The authors are grateful for the help with the statistical analyses from Lars Brudin on the Analysis Part, Area Kalmar County.
The Swedish Nationwide Examine on Getting older and Care (http://www.snac.org) is financially supported by the Swedish Ministry of Well being and Social Affairs and the taking part county councils, municipalities and college departments. The funders didn’t contribute within the examine design, knowledge evaluation and in writing of the manuscript. Open Entry funding offered by Linnaeus College.
Division of Well being and Caring Sciences, College of Well being and Life Sciences, Linnaeus College, Kalmar, Sweden
Cecilia Fagerström
The Analysis Part, Area Kalmar County, Kalmar, Sweden
Cecilia Fagerström
Division of Neurobiology, Care Sciences and Society, Getting older Analysis Heart, Karolinska Institutet and Stockholm College, Stockholm, Sweden
Anna-Karin Welmer
Division of Physiotherapy, Division of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
Anna-Karin Welmer
Division of Geriatric Drugs, Division of Medical Sciences in Malmö, Lund College, Malmö, Sweden
Sölve Elmståhl
Division of Well being and Caring Sciences, College of Well being and Life Sciences, Linnaeus College, Växjö, Sweden
Hanna Tuvesson
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CF designed the examine, carried out the statistical analyses, together with knowledge analyses, and drafted the manuscript along with HT. A-KW and SE contributed to the design of the examine, the info assortment and the mental content material. All of the authors learn and accredited the ultimate manuscript.
Correspondence to Hanna Tuvesson.
The Ethic overview board of Lund College (LU 128–00, LU 604–00, LU 744–00) accredited the SNAC Blekinge and GÅS research and the Ethic overview board of Karolinska Institutet, Stockholm (KI 01–114) accredited the SNAC Kungsholmen. Each written and verbal knowledgeable consent was obtained from all contributors.
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Fagerström, C., Welmer, AK., Elmståhl, S. et al. Life weariness, suicidal ideas and mortality: a sixteen-year longitudinal examine amongst women and men older than 60 years. BMC Public Well being 21, 1359 (2021). https://doi.org/10.1186/s12889-021-11329-z
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Acquired: 26 August 2020
Accepted: 18 June 2021
Printed: 09 July 2021
DOI: https://doi.org/10.1186/s12889-021-11329-z
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