Abstract：
OBJECTIVE: Suicide rates in older adults are often the highest of any age group, particularly among high income countries. However, there is a limited understanding of the factors that could protect against suicidality in older age. This systematic review aimed to identify and evaluate the psychological factors that protect against suicidality in older age.
METHODS: An a priori protocol was established and registered on PROSPERO (CRD42022343694). EMBASE, MEDLINE, PsycINFO, Web of Science and Scopus were searched. Papers were quality assessed using the Quality Assessment with Diverse Studies (QuADSs) tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Seventeen papers were included and narratively synthesised.
RESULTS: The initial searches identified 10,673 records, resulting in the screening of 5441 records after the removal of duplicates. The protective factors identified were (1) meaning/purpose in life, (2) reasons for living, (3) coping styles, (4) psychological wellbeing, (5) life satisfaction, (6) personality factors, (7) cognitive functioning, and (8) sense of belonging. The factors with the most empirical support were meaning in life, followed by psychological wellbeing and coping responses, such as primary control strategies, and personality traits, such as positive affect and agency. There was also evidence to suggest that the influence of some protective factors, for example meaning in life, may depend upon stage in older life and gender.
CONCLUSIONS: This review identified several psychological factors that have been found to protect against suicidal ideation in older adults, representing potential treatment targets for reducing suicide in older adults. Recommendations for future research includes greater use of longitudinal and case-control designs, measuring outcomes across the continuum of suicidality and using samples that allow comparison between younger and older adults and within the spectrum of old age.
METHODS: An a priori protocol was established and registered on PROSPERO (CRD42022343694). EMBASE, MEDLINE, PsycINFO, Web of Science and Scopus were searched. Papers were quality assessed using the Quality Assessment with Diverse Studies (QuADSs) tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Seventeen papers were included and narratively synthesised.
RESULTS: The initial searches identified 10,673 records, resulting in the screening of 5441 records after the removal of duplicates. The protective factors identified were (1) meaning/purpose in life, (2) reasons for living, (3) coping styles, (4) psychological wellbeing, (5) life satisfaction, (6) personality factors, (7) cognitive functioning, and (8) sense of belonging. The factors with the most empirical support were meaning in life, followed by psychological wellbeing and coping responses, such as primary control strategies, and personality traits, such as positive affect and agency. There was also evidence to suggest that the influence of some protective factors, for example meaning in life, may depend upon stage in older life and gender.
CONCLUSIONS: This review identified several psychological factors that have been found to protect against suicidal ideation in older adults, representing potential treatment targets for reducing suicide in older adults. Recommendations for future research includes greater use of longitudinal and case-control designs, measuring outcomes across the continuum of suicidality and using samples that allow comparison between younger and older adults and within the spectrum of old age.
摘要：
目标：老年人的自杀率通常是所有年龄组中最高的，特别是在高收入国家。然而,对于可以防止老年人自杀的因素了解有限。本系统评价旨在确定和评估防止老年人自杀的心理因素。
方法：在PROSPERO（CRD42022343694）上建立并注册了先验协议。EMBASE,MEDLINE,PsycINFO,搜索了WebofScience和Scopus。论文质量评估使用质量评估与多样化研究（QuADSs）工具。遵循系统审查和荟萃分析（PRISMA）指南的首选报告项目。包括17篇论文，并进行了叙述综合。
结果：最初的搜索确定了10,673条记录，结果在删除重复项后筛选了5441条记录。确定的保护因素是(1)生活中的意义/目的，（2）生活的原因，(3)应对方式,（4）心理健康，（5）生活满意度，（6）人格因素，（7）认知功能，（8）归属感。最有经验支持的因素是生活中的意义，其次是心理健康和应对反应，例如主要控制策略，和人格特质，如积极的影响和代理。也有证据表明，一些保护因素的影响，例如生活中的意义，可能取决于老年生活的阶段和性别。
结论：本综述确定了一些心理因素，这些因素已被发现可以防止老年人的自杀意念，代表减少老年人自杀的潜在治疗目标。未来研究的建议包括更多地使用纵向和病例对照设计，测量自杀连续体的结果，并使用允许比较年轻人和老年人以及老年范围内的样本。
方法：在PROSPERO（CRD42022343694）上建立并注册了先验协议。EMBASE,MEDLINE,PsycINFO,搜索了WebofScience和Scopus。论文质量评估使用质量评估与多样化研究（QuADSs）工具。遵循系统审查和荟萃分析（PRISMA）指南的首选报告项目。包括17篇论文，并进行了叙述综合。
结果：最初的搜索确定了10,673条记录，结果在删除重复项后筛选了5441条记录。确定的保护因素是(1)生活中的意义/目的，（2）生活的原因，(3)应对方式,（4）心理健康，（5）生活满意度，（6）人格因素，（7）认知功能，（8）归属感。最有经验支持的因素是生活中的意义，其次是心理健康和应对反应，例如主要控制策略，和人格特质，如积极的影响和代理。也有证据表明，一些保护因素的影响，例如生活中的意义，可能取决于老年生活的阶段和性别。
结论：本综述确定了一些心理因素，这些因素已被发现可以防止老年人的自杀意念，代表减少老年人自杀的潜在治疗目标。未来研究的建议包括更多地使用纵向和病例对照设计，测量自杀连续体的结果，并使用允许比较年轻人和老年人以及老年范围内的样本。
