Abstract
Background: Possible relationships between suicidal ideation and biopsychosocial predictors in older age are unclear. In the population-based Salus in Apulia Study, we investigated the relationships among biomarkers, socio-demographic, psychopathological, inflammatory and metabolic characteristics and suicidal ideation in 1252 older subjects. Methods: Suicidal ideation was evaluated with the brief version of the Columbia-Suicide Severity Rating Scale. Apolipoprotein E (APOE) genotype and inflammatory profile [interleukin (IL)-6, tumor necrosis factor (TNF)-α, C-reactive protein (CRP)] were evaluated. A machine learning algorithm, the Random Forest (RF), selected potential biopsychosocial factors associated to suicidal ideation. Results: Suicidal ideators accounted for 2.32 % of subjects, were female, smokers, and obese with multimorbidity. After adjusting for age, gender, education and social dysfunction, logistic regression analyses revealed that suicidal ideation was associated to late-life depression (LLD) (odds ratio:21.71,95 % confidence interval:9.22–51.14). In the full RF model, asthma was the most important contributor to suicidal ideation. In the final RF model, education, age, and mild cognitive impairment followed by gender and global cognition were considered the most important contributors. Among biomarkers, in the final RF model, IL-6 followed by TNF-α, APOE ε4 allele presence, CRP and high-density lipoprotein cholesterol contributed most to suicidal ideation. Limitations: A relatively small number of older subjects with suicidal ideation (2.3 %); we did not distinguish between active and passive suicidal ideation. Conclusions: Although LLD is a strong determinant of suicidal ideation, other non-psychiatric factors, i.e., serum inflammation biomarkers, APOE ε4 allele, and multimorbidity, should be taken into account when evaluating a suicidal ideation phenotype in older age.
| Original language | English |
|---|---|
| Pages (from-to) | 202-212 |
| Number of pages | 11 |
| Journal | Journal of Affective Disorders |
| Volume | 319 |
| Early online date | 23 Sept 2022 |
| DOIs | |
| Publication status | Published - 15 Dec 2022 |
Bibliographical note
Funding Information:This study was funded by the Italian Ministry of Health with “Ricerca Corrente 2019” Grant. The work reported in this publication was granted by the Italian Ministry of Health, under the Studies on Aging Network, at Italian Research Hospitals (IRCCS).
Funding Information:
We thank the MICOL Study group and the “Salus in Apulia” Research Team. This manuscript is the result of the research work on frailty undertaken by the “Research Network on Aging” team, supported by the resources of the Italian Ministry of Health—Research Networks of National Health Institutes. We thank M.V. Pragnell, B.A. for her precious help as native English language supervisor. We thank the General Practitioners of Castellana Grotte, for their fundamental role in supporting the recruitment of participants in these studies: Campanella Cecilia Olga Maria, Daddabbo Annamaria, Dell'aera Giosue’, Giustiniano Rosalia Francesca, Guzzoni Iudice Massimo, Lomuscio Savino, Lucarelli Rocco, Mazzarisi Antonio, Palumbo Mariana, Persio Maria Teresa, Pesce Rosa Vincenza, Puzzovivo Gabriella, Romano Pasqua Maria, Sgobba Cinzia, Simeone Francesco, Tartaglia Paola, Tauro Nicola. This study was funded by the Italian Ministry of Health with “Ricerca Corrente 2019” Grant. The work reported in this publication was granted by the Italian Ministry of Health, under the Studies on Aging Network, at Italian Research Hospitals (IRCCS).
Publisher Copyright:
© 2022 Elsevier B.V.
Keywords
- APOE
- Asthma
- IL-6
- Late-life depression
- Obesity
- Suicidal ideation
