Suicide risks, self-harm and loneliness among older adults: the influence of medications, bereavement and dementia

Research problem and specific questionsMedications play an important role for the mental health and suicidal behaviour (i.e. suicide and self-harm) among older people. This is however an understudied topic, which we aim to change with the proposed project.

We aim to investigate in older adults 1) Medication treatment before and after self-harm; 2) Medication patterns before suicide; 3) Medications, loneliness and bereavement; and 4) Co-designing prevention of suicidal behaviour and involuntary loneliness.Data and methodThe project combines quantitative analyses of high quality Swedish register data (Aim 1-3) with qualitative focus group interviews with key stakeholders (Aim 4).

We will analyse longitudinal data from several Swedish registers of people aged ≥65-years (n≈3.1 million).

Results from these analyses will serve as a foundation for the semistructured focus group interviews with key stakeholders, including user organisations, health care and eldercare.Relevance This multidisciplinary project integrates different research approaches and uses participatory designs, with the goal of co-designing preventive interventions for older adults.

We will use cutting-edge epidemiological methods based on registers with excellent data quality offering the possibility for long-term follow-up.

With these methodological advancements and big high quality data, we will be able to address the shortcomings of previous studies.

This project will also identify vulnerable high-risk groups for tailored interventions that could increase health and autonomy in older adults.Our focus on medications in this context is novel and highly relevant.

Medication treatment is very common among older adults and, thus, a natural point of intervention and potential identifier of loneliness and suicidal behaviour.Plan for project realisation We will start with the register-based studies (Aim 1-3) and the initiation of a Community Advisory Board of older adults.

Based on the findings from Aim 1-3, we will design focus group interviews with key stakeholders (Aim 4).

We will actively involve end users and health care and eldercare providers in the project to ensure that all important stakeholders are represented and provide input.Feasibility is ensured by availability of all necessary data in-house, and by the combined high and wide competence in our interdisciplinary team.The budget mainly covers funding for a PhD student and a postdoc for the scientific and outreach activities.