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Background: Older adults worldwide are at a greater risk of suicide than other age groups. There is a scarcity of prospective studies exploring risk factors for suicide in older people and their discriminative ability to identify future suicide.Methods: We examined a prospective cohort of senior Taipei City residents between 2005 and 2009 (N=101,764). Cox proportional hazards regression analysis was used to determine significant risk factors and to construct a predictive score. The accuracy of the derived score in the prediction was tested by Receiver Operating Characteristic analysis.Results: Male sex (Hazard Ratio [HR]=3.41, p<0.001), lower education (HR=3.31, p<0.001) and lower income (HR=2.52, p=0.01) were associated with an increased risk of suicide, as well as depressed mood (HR=1.44, p=0.02; per unit increase in a 4-point scale) and insomnia (HR=1.30, p=0.03; per unit increase in a 4-point scale). The derived prediction score yielded a sensitivity of 0.63 a specificity of 0.73 and an area under curve of 0.73. Removing depressed mood from the prediction model did not significantly alter suicide predictability (P=0.11).Limitations: The dataset examined did not contain information regarding to important risk factors such as substance misuse and prescribed medications and the measures of mental health were relatively limited.Conclusion: Prediction of suicide based on factors recorded in a routine health screen of elderly people was unsatisfactory; the strongest predictors were factors that cannot be easily altered. Further understanding of how the socioeconomic condition of seniors contributes to suicide may provide valuable insights for intervention targeting this growing population-at-risk. [ABSTRACT FROM AUTHOR]

Background: Studies from Western countries indicated that older adults were more resilient than younger ones to deteriorating mental health during the COVID-19 pandemic. As high late-life suicide rates have been reported in East Asia, it is possible that the pandemic impact might differ between East and West. We investigated the pandemic impact on age-specific suicide patterns in Taiwan., Methods: Interrupted time-series analysis was used to model the overall, and age-stratified, monthly suicide rates before (January 1st, 2017 to December 31st, 2019) and after (January 1st 2020 to December 31st 2021) the COVID-19 outbreak. Associations between confirmed COVID-19 deaths and suicide rates were also assessed., Results: There was a significant decrease in overall suicide rates after the COVID-19 outbreak (p < 0.01) (annual average rates per 100,000 population of 16.4 prior, 15.2 after). The overall decrease was driven by fewer suicide deaths in the young- and older-middle-aged groups (25-44 and 45-64 years). However suicide rates in younger-age group (<25 years) were already increasing pre-pandemic, a trend which continued after the outbreak. Suicide rates for older people (≥65 years) also increased along with the increasing number of COVID-19 deaths during the pandemic period., Limitations: Under-reporting and/or misclassification of suicides were possible., Conclusions: The overall suicide rates in Taiwan did not change after the COVID-19 outbreak; however, suicide in older adults increased. Public health measures to reduce COVID-19 infections may have unintended and adverse consequences on the psychological wellbeing of older citizens., Competing Interests: Conflict of interest None declared., (Copyright © 2023. Published by Elsevier B.V.)

Background: The global age-standardized suicide rate fell by 32.7% between 1990 and 2016. The decrease was largely due to suicide rate reductions in China and India. High-income Asian regions did not see such reductions. The aim of the current study was to explore recent suicide rate trends in Hong Kong and Taiwan to decompose which factors - age, period or cohort - explain suicide rate changes in these two regions., Methods: Official mortality data for 1979-2018 in Hong Kong and Taiwan were collected. We utilized Web Tool from the NIH (National Institute of Health, USA) to analyze the Age-Period-Cohort (APC) effects., Results: We found marked age-effect that suicide rates increased with age in both genders in both places. Period effect related to the dissemination of charcoal burning suicide was found during 1999-2003 in Hong Kong and 2004-2008 in Taiwan. Increasing suicide rates in the middle- and young-age male cohorts were found in both regions. No increase in suicide risks in young female cohorts was observed. Older cohorts in Hong Kong and older female cohorts in Taiwan also had high suicide rates, but older male cohorts in Taiwan had low rate., Limitations: The interpretations and observations at the population level might not hold at the individual level., Conclusions: The high suicide risk in middle- and young male cohorts in both regions contribute to the persistent high suicide rates in these two regions. Special attention should be turn to the factors underlying such increasing trends., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Suicides by carbon monoxide poisoning from burning charcoal increased markedly and contributed to a rise in overall suicides in Taiwan in the early 2000s. A previous study indicated short-term effectiveness on reducing suicides of a charcoal restriction programme, which involved voluntary actions from large chain retail stores to move charcoal bags from open shelves to locked cabinets starting from 1st May 2012, in New Taipei City, Taiwan. We investigated the longer-term effect of this programme., Methods: We calculated quarterly age-standardised charcoal-burning and overall suicide rates in New Taipei City and two comparison cities in 2007-2017. Controlled interrupted time-series analysis was used to examine the effect of the charcoal restriction programme., Results: There was no difference between the intervention and comparison cities in step changes in the rates (per 100,000) of charcoal-burning suicide (intervention minus comparison = -0.336, 95% confidence interval -1.173 to 0.502) and overall suicide (-0.270, -1.844 to 1.303) after the intervention, or changes in trends (slopes) in charcoal-burning suicide rates (0.007, -0.055 to 0.069) and overall suicide rates (0.049, -0.138 to 0.236) before and after the intervention., Limitations: There was no legislative requirement to enforce the charcoal restriction. The programme was also restricted to a subset of retail stores., Conclusion: The charcoal restriction programme in New Taipei City showed no effect on reducing charcoal-burning or overall suicides in the five years after its implementation. Future means restriction strategies for suicide prevention should optimise the programme sustainability, ensure the comprehensive means restriction, and monitor the long-term intervention effectiveness., (Copyright © 2020. Published by Elsevier B.V.)