Zolpidem as a high risk factor for elderly suicide in South Korea

Backgrounds: South Korea, a nation with rapidly aging population, has the highest suicide rates in the world, and the elderly have a suicide rate three times higher than the national average. We classified the drugs ingested for suicide attempts by age groups and compare the clinical outcomes between non-elderly and elderly patients who attempted suicide by ingesting drugs. Materials and methods: Data were obtained from the nationwide Emergency Department-Based Injury Surveillance of the Korea Centers for Disease Control and Prevention, South Korea between January 2011 and December 2016. Results: There were 12,104 patients who attempted suicide by ingesting drugs, of whom the elderly (73.5%) ingested more sedatives and hypnotics than the non-elderly (53.9%); of these drugs, zolpidem ingestion was higher in the elderly than the non-elderly. Conversely, the non-elderly ingested more antipsychotics and antidepressants (15.9%) and analgesics (10.8%) than the elderly (7.4% and 2.8%, respectively). The elderly had longer hospital stay, higher intensive care unit (ICU) admission rate, and higher mortality rate than the non-elderly: more elderly patients (30.2%) were admitted to the ICU than the non-elderly (15.7%); the duration of hospital stays was 6.27 ± 11.35 days in the elderly and 8.94 ± 14.85 days in the non-elderly; and the mortality rate was 0.4% in the non-elderly and 3.0% in the elderly. Conclusion: Findings suggest that zolpidem has become the greatest risk factor for the elderly Koreans in suicide attempts. Further prevention efforts are needed to prevent suicide among the elderly.