The 5D indicators of suicide risk in older adults who are lonely.

Loneliness is associated with suicide ideation, attempts, and deaths in later life. The objective of this study is to describe characteristics of suicide risk among older adults who report clinically significant loneliness grounded in our conceptual model of the 5Ds of late life suicide. Our sample comprises 291 adults aged 60 years and older who screened positive for loneliness (UCLA 3-Item Loneliness Scale score of 6 and above) and subsequently completed baseline eligibility interviews for a clinical trial. Interviews obtained information on loneliness severity, suicide ideation, and the 5Ds of late life suicide: (1) depression (PROMIS depression), (2) deadly means (firearms access), (3) disease (number of chronic conditions), (4) disconnection (objective disconnection, Lubben Social Network Scale; subjective disconnection, UCLA Loneliness Scale), and (5) disability (World Health Organization Disability Assessment Schedule). Subjects demonstrated a high frequency of characteristics associated with suicide risk, with the most common presentation (38%) being the presence of 3Ds-subjective disconnection (loneliness), multimorbidity, and disability. While few subjects presented with only subjective disconnection (loneliness), there was diversity in which other Ds were present and in which combination, suggesting heterogeneous presentations. Upstream suicide prevention efforts could target older adults with loneliness to reach a population with numerous compounding indicators of risk.