In our study, it was determined that elderly suicides constituted 13.8% of all suicides and increased gradually over the years during the 10-year period in Denizli. In studies conducted in different cities of Turkey, the rate of elderly suicides to the total number of suicides was reportedly between 6.2% and 11.5% (Hilal et al. 2010; Karbeyaz et al. 2017; Timur et al. 2017; Akin et al. 2019). Similarly, in studies conducted in different countries, it has been reported that the suicide rate in the elderly group is higher than that in other age groups, and the suicide rate in the elderly is gradually increasing (Özer et al. 2016; Steele et al. 2018; Kim and Lee 2020). The fact that the elderly population in Denizli is higher than the average elderly population of Turkey and that the decline in supportive family structure today are thought to be associated with the increase in elderly suicides in Denizli.
Similar to the literature, it was noted that majority of the elderly who committed suicide in Denizli Province (82%) were men. Similar to the overall population, it has been reported that men showed a trend of committing suicide more frequently in the elderly population, and being a man is a risk factor for elderly suicides (Steele et al. 2018; Crestani et al. 2019; Tan and Cheung 2019; Kim et al. 2019). The higher rate of suicide in men may be attributable to that fact that with the advancing age they are more likely to face factors such as losing social connections and being alone, losing social status more significantly depending on their gender-defined roles, and predisposition to chronic diseases.
According to the Turkish Statistical Institute, it has been reported that most people aged ≥ 65 years committed suicide by hanging (Özer et al. 2016). Likewise, studies conducted worldwide have revealed that the elderly most frequently commit suicide by hanging (Steele et al. 2018; Crestani et al. 2019; Kim et al. 2019). It has been reported that hanging was the more frequently preferred method of suicide due to its higher lethality and the ready availability of used materials (Karbeyaz et al. 2017; Demir et al. 2018; Crestani et al. 2019). In Denizli, it has been observed that hanging is the most frequently used method among elderly suicides. It is also noteworthy that although firearm suicide among men was the second most common method, women do not choose this method at all. Reportedly, there is a strong relationship between firearm ownership and firearm suicide rate, and that the number of men who own a firearm gradually increased after 1990 (Siegel and Rothman 2016). It has been stated that firearm suicide is mostly preferred by men when compared with women, since there is a need for more information on how a firearm works and the firearm causes a dramatic deformity (Crestani et al. 2019). In our study, it was observed that jumping from a height was the second most common method of suicide in women. According to TURKSTAT data, it was noted that jumping from a height was the second most common method among elderly female suicides in Turkey, and in other studies, it was the second in Erzurum and the third in Izmir (Özer et al. 2016; Timur et al. 2017; Akin et al. 2019).
Spending more time at home owing to factors such as difficulty in walking, limitation of movement, and social isolation was found to be associated with higher incidence of suicides at home in the elderly (Conwell and Thompson 2008; Rahimi et al. 2015; Steele et al. 2018). Consistent with the literature, the majority of elderly suicides (88.5%) in Denizli occurred in the home and its annexes.
Since no information about the cause of suicide could be obtained from the crime scene investigation and examination of deceased and autopsy reports, the reasons for suicide of the cases were not included in this study. Another reason of cause of suicide for not being included in the study is that the information on the presence or absence of psychiatric diseases in the history of the cases could not be acquired. Studies have shown that clinical and psychosocial factors; a history of psychiatric or mental disorder, previous suicide attempts, a history of alcohol abuse, stressful life events, and lack of social support all increase the risk of suicide (Kalkan Oguzhanoglu et al. 2018; Moitra et al. 2021).