Marnin J. Heisel, PhD, C.Psych, Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Paul S. Links, MD, FRCP(C), Arthur Sommer Rotenberg Chair in Suicide Studies, Suicide Studies Unit, Department of Psychiatry, University of Toronto/St. Michael’s Hospital, Toronto, ON.

Older adults have high rates of suicide worldwide. Suicide rates increase with advancing age, and older adults typically use highly lethal means of self-destruction. In addition, suicidal older adults tend to pursue treatment in primary care rather than mental health settings, but current limitations in the primary care system potentially restrict suicide prevention in older patients. We briefly review the epidemiology of late-life suicide and suggest modifications in primary care to better address the psychosocial needs of at-risk older adults, supported by research on suicide risk and resiliency, clinical assessment and treatment options, and collaborative models of primary medicine and mental healthcare.
Key words: suicide, suicide ideation, suicidal behaviour, older adults, primary care.

Margda Wærn, MD, PhD, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg, Sweden.

Seniors who commit suicide often consult their doctors a short time before they take their lives, but few communicate their suicide intent. Rather, they may focus on somatic complaints. This paper reviews the literature on the connection between physical illness and suicide. Recent research shows that over half of those who commit suicide late in life suffer from serious physical illness or impairment. The association between physical illness and suicide may be stronger in men than in women. Since most physically ill persons who commit suicide suffer from depression, depression should be treated aggressively in seniors with concomitant physical disorders.
Key words: suicide, suicide attempts, physical illness, depression, elderly.