Emergency department visits for nonfatal self-inflicted injuries among adults aged 65 and older — United States, 2005

Suicidal behavior among older adults is reported to be more medically serious than similar behavior among younger adults. However, the characteristics of self-inflicting injury (SII) and nonfatal suicidal behavior among the older adults are poorly understood. This study examines SII among adults aged 65 years and older to identify prevention opportunities. We performed a descriptive analysis of emergency department (ED) visits for SII from the National Electronic Injury Surveillance System All Injury Program-SII special study (NEISS-AIP). To characterize SII, ED visits were compared between older adults (65 years and older) and younger adults (20-64 years). In 2005, the NEISS-AIP had 4,478 adult ED visits for SII; 114 of these occurred among the older adults (weighted US estimate: 7,104). Preliminary weighted results show that the older adults had a higher percent of ED SII visits deemed suicidal by ED providers than younger adults (70.7% versus 56.1%, p=0.002) and a higher percent of hospitalization following suicide attempt than younger adults (74.1% versus 55.0%, p=0.010). Generally, a smaller percent of the older adults whose SII was suicidal had a history of mental/behavioral disorders (e.g., previous self-harm, bipolar disorder, anxiety, substance use) compared to younger adults. However, similar to younger adults, a high proportion of older adults had a history of depression (74.4% versus 69.5%, p=0.447). Over 7,000 SII-related ED visits occur among the older adults and the majority result in hospitalization. Comprehensive strategies that include addressing clinical depression must be developed to prevent suicide-related morbidity and mortality among older adults.