Italy is not a country for old people: 37% of suicides are among the elderly

Loneliness and ageism, i.e. discrimination based on age, trigger a process that leads to depression. In fact, suicides among the elderly account for 37% of all suicides, although the elderly make up 24% of the general population. The phenomenon mainly affects men, cities and people over 80.

Italy proves to be a particularly difficult country for the elderly, not only because of physical pathologies, but especially because of the burden of loneliness. A phenomenon that has serious consequences on mental and physical health. Loneliness is often a prelude to depression, which increases the risk of other pathologies and suicide. The rate of loneliness is twice as high as the average for European countries: those who have no one to whom they can ask for help are 14%, and those who have no one to whom they can tell personal things are 12%, compared with a European average of 6.1% (Eurostat data). Loneliness is not only a social problem, but also a clinical one, being associated with an increased risk of depression, sleep disorders, dementia and cardiovascular diseases. These issues were the focus of the 25th Congress of the Italian Association of Psychogeriatrics, organised in Padua from 27 to 29 March.

Social determinants, i.e. factors influencing health such as economic, housing and relational conditions, have a significant impact on the health of older people, although they have come to the attention of clinicians too late and are still too often neglected. According to the World Health Organisation, the impact of social determinants is equal if not greater than medical care. Therefore, ignoring these conditions poses a serious risk to people. Loneliness is a social epidemic that increases the risk of dementia by 50% and premortality by 30%; its impact is comparable to chronic smoking and obesity.

Some countries have tools such as guidelines or recommendations to deal with this reality. In Italy there is still no defined approach, despite being the oldest country in the world after Japan. Several elements contribute to worsening the situation: among them, in addition to ageism, the depopulation of historic centres, the closure of local shops, and the proliferation of scams against the elderly. These elements trigger a process of debasement that leads to depression and often to suicide: suicides among the elderly are in fact 37% of the total, although the elderly make up 24% of the general population. The reason for this figure lies in the fact that our elderly are among the least 'considered' in the world. This phenomenon mainly affects men, cities and people over 80: in these sub-populations the frequency of suicides has reached intolerable levels. The suicide of an elderly person is also a terrible sign for a young person, who receives a message not of resilience but of surrender.

The first symptoms of the consequences of an elderly person's social marginalisation on the psyche may emerge from sleep disturbances and the increased frequency of nightmares, which may in turn foster a depressive state. About 20 per cent of children and 6 per cent of adults have frequent nightmares. Persistent nightmares that interfere with daily life can be diagnosed as 'nightmare disorder', a mental health condition in which frequent and stressful nightmares can make it difficult to get through the day. The frequency of nightmares increases with age: the prevalence is more than three times higher among those over 70 years old (6.3 per cent) than among adults between 50 and 70 years old (1.8 per cent). An association with suicidal ideation, depression and stress was also found. There is a strong correlation between nightmares and suicide risk: individuals with frequent nightmares are more likely to attempt suicide and engage in self-harming behaviour.