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Psychiatry"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Epidemiological research on self\u2010harm in older adults (aged 65+ years) remains scarce despite its growing public health significance amid global ageing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to analyse the global burden, risk factors and projections of self\u2010harm mortality in adults aged 65+ years from 1990 to 2050.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Utilising data from the Global Burden of Disease Study 2021, this research examined the spatiotemporal patterns of self\u2010harm mortality and years of life lost by age, gender and socio\u2010demographic index (SDI) in adults aged 65+ across 204 countries and territories (grouped into 21 regions) from 1990 to 2021. It also explored the changes during the coronavirus disease 2019 pandemic, identified key risk factors and projected the future burden of self\u2010harm mortality through 2050.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Global self\u2010harm deaths among older adults increased from 116\u00a0642 in 1990 to 167\u00a0920 in 2021, a rise of 43.96%. However, the age\u2010standardised mortality rate (ASMR) decreased by 39.56%, from 36.83 to 22.26 per 100\u00a0000. In 2021, central sub\u2010Saharan Africa had the highest ASMR at 61.35 per 100\u00a0000, while North Africa and the Middle East recorded the lowest at 4.88 per 100\u00a0000. Male ASMR was 2.5 times as high as that of females (33.61 vs. 13.58 per 100\u00a0000), and adults aged 85 years and older were at particularly elevated risk. High alcohol use was identified as a major risk factor, especially for males. A U\u2010shaped relationship between ASMR and the SDI was observed, with the lowest point at an SDI of approximately 0.70. Projections indicate a further 46.05% decline in ASMR to 12.01 per 100\u00a0000 by 2050.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results highlight complex global trends in self\u2010harm mortality and associated risk factors among older adults, emphasising the urgent need for sex\u2010, age\u2010, and region\u2010specific interventions, enhanced social support and systematic risk monitoring to inform age\u2010friendly self\u2010harm prevention policies, and sustainable development support goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/gps3.70019","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:39:17Z","timestamp":1777901957000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global burden, risk factors and projections of self\u2010harm mortality in adults aged 65+ years: A 60\u2010year trend analysis from the Global Burden of Disease Study 2021"],"prefix":"10.1002","volume":"39","author":[{"given":"Jinjie","family":"Xu","sequence":"first","affiliation":[{"name":"Beijing Key Laboratory of Intelligent Drug Research and Development for Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders Beijing Anding Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiman","family":"Guo","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Intelligent Drug Research and Development for Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders Beijing Anding Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zizhao","family":"Feng","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Intelligent Drug Research and Development for Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders Beijing Anding Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiti","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengwei","family":"Guo","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Intelligent Drug Research and Development for Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders Beijing Anding Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Feng","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Intelligent Drug Research and Development for Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders Beijing Anding Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30925\u20109"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s42949\u2010021\u201000023\u2010z"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(18)32225\u20106"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2015.1055552"},{"key":"e_1_2_12_6_1","unstructured":"UN. 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