Journal of Datta Meghe Institute of Medical Sciences University

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 16  |  Issue : 2  |  Page : 244--247

Suicide and its risk factors among elderly in Central India: A cross-sectional study


Kumar Sourabh1, Lovely Kumari2, Shashank Gotarkar2, Abhishek Ingole2, Abhay Mudey2,  
1 Department of Community Medicine, Datta Meghe Medical College, Nagpur, Maharashtra, India
2 Department of Community Medicine, Jawaharlal Nehru medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India

Correspondence Address:
Dr. Abhishek Ingole
Department of Community Medicine, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra
India

Abstract

Introduction: The 21st century is often called as the “Age of Ageing.” Globally, the share of older people who are above 60 years of age grew from 9.2% in the year 1990–2011, 7% in the year 2013, and following this trend, it will reach to 21.1% by the year 2050. Aim and Objective: The aim of this study is to determine the risk factors of suicides in the elderly population who committed suicide. Methodology: The study was a community-based cross-sectional study conducted in the Wardha district, located in the Central part of India from July 2015 to October 2017. The total cases of suicides among elderly population of more than or equal to 60 years, recorded with the appropriate authority during the year 2013–2014 and 2014–2015 was included in this study. The study participants were the survivor of suicide (people intimately and directly affected by a suicide), who was knowledgeable about the events or circumstances, leading to the suicide by the elderly. Results: problems faced by elderly that led them to suicide. Near about all the elderly (98.6%) except one were having some mental health issues in the form of anxiety and depression. Furthermore, about 78.9% of study participants were having clinical comorbidities in the form of chronic physical pain, major accident or paralysis, history of fits, stupor, loss of consciousness, and chronic illness such as tuberculosis or cancer. Conclusions: In the present study, near about half of the elderly were in the age group of 60–69 years of age. While maximum elderly who committed suicide were male by gender indicating, male gender is more prone for suicide.



How to cite this article:
Sourabh K, Kumari L, Gotarkar S, Ingole A, Mudey A. Suicide and its risk factors among elderly in Central India: A cross-sectional study.J Datta Meghe Inst Med Sci Univ 2021;16:244-247


How to cite this URL:
Sourabh K, Kumari L, Gotarkar S, Ingole A, Mudey A. Suicide and its risk factors among elderly in Central India: A cross-sectional study. J Datta Meghe Inst Med Sci Univ [serial online] 2021 [cited 2021 Dec 9 ];16:244-247
Available from: http://www.journaldmims.com/text.asp?2021/16/2/244/328462


Full Text



 Introduction



The 21st century is often called as the “Age of Ageing”. Globally, the share of older people who are above 60 years of age grew from 9.2%in the year 1990–2011. 7% in the year 2013, and following this trend, it will reach to 21.1% by the year 2050.

According to the United Nation Population Division, the population of people above 60 years in India is expected to rise dramatically and it may reach to 19% in 2050 from 8% in the year 2010. The problems in the elderly are usually multiple and often masked by sensory and cognitive impairments, which contribute to worsening of morbidity and mortality.

Suicide is a complex human behavior, and it involves different aspects of an individual's personality, state of health, and life circumstances. The lethality of method of suicide is very high among the elderly and it is more likely to be missed due to their indirect method of communication regarding the suicide intent. The effects of physical health factors on suicide in elderly people are generally mediated by mental health factors. Suicide is more likely to be missed in elderly because they do not convey their feelings to others and the chance of survival becomes less in the elderly who lives in social isolation. Hence, the present study was planned to assess the probable reasons which may have led the elderly to commit suicide based on the information provided by survivors of suicides in elderly.

 Methodology



The study was a community-based cross-sectional study conducted in the Wardha district, located in the Central part of India from July 2015 to October 2017. The Wardha district is located in Nagpur division with total area of 6310 square km. The total cases of suicides among elderly population of more than or equal to 60 years, recorded with the appropriate authority during the year 2013–2014 and 2014–2015, were included in this study. The study participants were the survivor of suicide (people intimately and directly affected by a suicide), who was knowledgeable about the events or circumstances, leading to the suicide by the elderly. A predesigned and prestructured questionnaire was used for the collection of data. Duly explained informed written consent was obtained from all participants of the study in their local language, and the information obtained is kept confidential. A total of 86 elderly suicides were enlisted. Fifteen survivors of suicides could not be contacted or did not give consent to participate in the study. Hence, the information obtained from 71 survivors of suicides was analyzed further.

 Observations and Results



It was observed that 56.3% of the elderly who committed suicide were of the age group of 60–69 years followed by 33.7% in the age group of 70–79 years. Furthermore, 87.3% were males by gender and 33.4% were either widow or widower, but 92% of the elderly were living in a joint family at the time of committing suicide.

Risk factors for suicide

[Table 1] shows the problems faced by elderly that led them to suicide. Near about all the elderly (98.6%) except one were having some mental health issues in the form of anxiety and depression. Furthermore, about 78.9% of study participants were having clinical comorbidities in the form of chronic physical pain, major accident or paralysis, history of fits, stupor, loss of consciousness, and chronic illness such as tuberculosis or cancer., whereas 53.5% were having interpersonal issues with spouse and children and 42.3% were having agricultural problems. About 5.6% of study participants had attempted suicide previously. Thus, the mental health problems and clinical comorbidities were the most common problems faced by the elderly as perceived by the survivor [Figure 1].{Table 1}{Figure 1}

From the above table, we came to know out of all 71 study participants, 44 elderlies had taken loan for their requirement. Out of all those, who had taken loan from bank, about 81.5% elderly had taken loan for agricultural work. While, out of all those who had taken loan from microfinancing agencies, 40% elderly had taken loan for agricultural work, and for marriage of the family member each. From the above table, it is also evident that maximum loan was taken for agriculture purpose (63.6%). The association between funding agency and purpose of taking loan were found to be statistically highly significant (P < 0.001) [Table 2].{Table 2}

Events related to suicide

[Table 3] shows that 28.2% elderly had committed suicide by nonviolent method that is by consuming insecticides, while 71.8% elderly had committed suicide by violent method. It included hanging 42.2%, drowning 28.2%, and self-immolation 1.4%. Thus, hanging was the most common way to commit suicide in my study participants.{Table 3}

When compared the age of elderly and manner of suicide, it was observed that, among the age group of 60–69 years, 41.6% used drowning and 30.6% consumed insecticides as the manner of suicide; among the age group of 70–79 years, 67.8% used hanging as the manner of suicide; and among the age group of 80 years or above, 57.1% consumed insecticide as a manner of suicide. This association of age group with manner of suicide was found to be statistically significant with the P = 0.006. Thus, from [Table 4], we can conclude that, as more the age of elderly, more are the chances to prefer the nonviolent manner of the suicide by them.{Table 4}

 Discussion



In the present study, it was found that about 56.3% of elderly were in the age group of 60–69 years followed by 33.7% were in the age group of 70–79 years. Furthermore, more than 75% of the elderly who committed suicide were male by gender.

In the present study, it was found that, out of all the elderly who committed suicide and included in this study, 56.3% of elderly belonged to the age group of 60–69 years and male suicide was more. According to the Census 2011, there is a decrease in population strength as the age group increases which can be a reason to find the same trend in terms of suicide. The National Crime Records Bureau data of 2015 also reports more male suicide than female suicide in the age group of 60 years and above. Almost half of the elderly faced some of the other agricultural problems. When the survivors of suicide were enquired about their opinion concerning reason for suicide by the elderly, the most common explanation offered was indebtedness. In the book Agrarian Crisis and Farmers Suicide by Deshpande and Arora, it is mentioned that suicide in farmers was seen mainly because of crop failure, indebtedness, or loss of agricultural trade. The study of Srivastava et al. shows that financial problems related to unemployment and difficulty in the repayment of the loan were the reason for attempting suicide.

About 28.2% of elderly had committed suicide by nonviolent method that is by consuming insecticides. A study by Adityanjee found that the most common agents used are insecticides. Similarly, a study by Saddichha found that hanging and insecticide poisoning were the most common methods used to commit suicide.[1],[2],[3],[4],[5],[6],[7],[8],[9],[10]

 Conclusions



The present study depicts the status of elderly and the factors which may be the reason for the elderly to commit suicide. Usually, the disease process in the elderly is multiple and the duration and severity are longer for the aged.

In the present study, nearly about half of the elderly were in the age group of 60–69 years of age. While maximum elderly who committed suicide were male by gender indicating male gender are more prone for suicide. Nearly all the elderly were having some mental health problems in the form of anxiety and depression as perceived by survivor, whereas more than 3/4th were having clinical comorbidities. Furthermore, more than half of the elderly were having some interpersonal relationship problems and about 40% were having agricultural problems. About more than half of the elderly had taken loan for their personal needs. Out of all those who had taken loan, maximum elderly had taken loan from bank and near about 2/3rd had taken loan for agricultural reason. While the association between funding agency and purpose of taking loan was found to be statistically highly significant. Furthermore, maximum elderly preferred violent method of suicide and out of all about 40% of elderly preferred hanging as a method of suicide, whereas more than half of all the elderly of age 80 years and above preferred nonviolent method of suicide indicating that, as the age of elderly increased, more were the chances to prefer nonviolent method of suicide. The association between the manner of suicide and age was found to be statistically significant.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Situation Analysis of The Elderly in India, 2011 Central Statistics Office Ministry of Statistics and Programme Implementation, Government of India.
2World Population Ageing. Available from: http://www.un.org/esa/population/publications/worldageing19502050/. [Last accessed on 2020 Jan 18].
3Census 2011 India. Available from: http://www.census2011.co.in/. [Last accessed on 2020 Jan 18].
4Deshpande RS, Arora S. Agrarian Crisis and Farmer Suicides. India: SAGE Publications; 2010. p. 460.
5Adsi-2015-Full-Report.pdf. Available from: http://ncrb.nic.in/StatPublications/ADSI/ADSI2015/adsi-2015-full-report.pdf. [Last accessed on 2020 Jan 18].
6Definitions,Suicide,Violence Prevention,Injury Center,CDC. Available from: https://www.cdc.gov/violenceprevention/suicide/definitions.html. [Last accessed on 2020 Jan 18].
7ElderlyinIndia_2016.pdf. Available from: http://mospi.nic.in/sites/default/files/publication_reports/ElderlyinIndia_2016.pdf. [Last accessed on 2020 Jan 18].
8Berman AL. Estimating the population of survivors of suicide: Seeking an evidence base. Suicide Life Threat Behav 2011;41:110-6.
9Srivastava MK, Sahoo RN, Ghotekar LH, Dutta S, Danabalan M, Dutta TK, et al. Risk factors associated with attempted suicide: A case control study. Indian J Psychiatry 2004;46:33-8.
10Saddichha S, Prasad MN, Saxena MK. Attempted suicides in India: A comprehensive look. Arch Suicide Res 2010;14:56-65.