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The persistent high elderly suicide rates remain an understudied public health problem despite their importance. Suicide, in old age, is often viewed as a rational decision, triggered by loss, illness, disability, and depression. Neither the traditional medical model, which emphasizes the role of psychopathology (especially depression, psychosis, and alcohol and drug abuse), nor the psychosocial models that emphasize the role of social isolation and burdensomeness adequately explains the age-related increase in suicide rates. The importance of different vulnerability factors and certain life-events relative to suicidal behavior may change across the life span. Decision-making deficits due to cognitive decline, and in particular poor cognitive control, are more common in old age. Suicide follows a decision process, and recent studies have shown that suicidal individuals often make disadvantageous decisions in other situations. There is accumulating evidence that impaired cognitive control, deficits in social processing, and impulsivity—expressed in poor decisions both in experimental paradigms and in the context of real-world decision-making—may contribute to the decision to take one's life.

DOI: 10.1007/978-3-319-09964-4_10

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