Suicide mortality among the elderly population in Italy: A nationwide cohort study on gender differences in sociodemographic risk factors, method of suicide, and associated comorbidity

Objectives This study aimed at investigating gender differences in the relationship between sociodemographic factors and suicide mortality, as well as in the method used for suicide and the presence of comorbidities in an older population in Italy. Methods/Design We conducted a historical cohort study based on individual record linkage across the 15th Italian Population Census, the Italian Population Register, and the National Register of Causes of Death. Suicides among people aged 75 years or older from 2012 to 2017 were analyzed. Crude mortality rates were computed, and cause‐specific mortality rate ratios were estimated using negative binomial regression models. Chi‐square tests were used to evaluate significant gender differences in suicide methods and comorbidities associated with suicide. Results The study included 9,686,698 individuals (41% men, 59% women). Compared to living alone, living with children or partners reduced suicide mortality, especially among men. Having high or medium educational levels was associated with lower mortality than low educational levels among men. Foreign citizens had lower mortality among men, but not among women. Living in urban areas was associated with lower suicide rates in men and higher rates in women. Methods of suicide significantly differed by gender: leading methods were hanging, strangulation, and suffocation in men, and falling from height in women. Mental comorbidity was significantly more frequent among women, especially at ages 75–84 years. Conclusions We believe that our findings might help to promote public health strategies taking gender differences in old age into account to improve social support and quality of life of older men and women. Key points In Italy, sociodemographic factors influence suicide mortality in old age to a different extent in men and women Suicide mortality is significantly associated with the living arrangement, level of education, citizenship, and degree of urbanization of the municipality of residence, with important gender differences Gender differences also exist in the choice of suicide method and in the pattern of comorbidities associated with suicide Understanding gender differences in suicide mortality in later life would help to improve social support and quality of life for older men and women