Suicide in Older Adults: The Role of Emotions and Cognition

Kiosses, Dimitris N.; Szántó, Katalin; Alexopoulos, George S.

doi:10.1007/s11920-014-0495-3

Cited by 70 publications

(47 citation statements)

References 82 publications

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“…It is well known that ethnicity, age, gender and cognitive burden are risk factor for late life suicidality[41, 42]. While younger age predicted improvements at 36 weeks, gender, ethnicity and cognition did not predict changes in suicidal ideation at any time point.…”

Section: Discussionmentioning

confidence: 94%

Problem-Solving Therapy Reduces Suicidal Ideation In Depressed Older Adults with Executive Dysfunction

Gustavson

Alexopoulos

Niu

et al. 2016

The American Journal of Geriatric Psychiatry

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Objective To test the hypothesis that Problem Solving Therapy (PST) is more effective than Supportive Therapy (ST) in reducing suicidal ideation in older adults with major depression and executive dysfunction. We further explored whether patient characteristics, such as age, gender and additional cognitive impairment load (eg: memory impairments) were related to changes in suicidal ideation over time. Design Secondary data analysis using data from a randomized clinical trial allocating participants to PST or ST at 1:1 ratio. Raters were blind to patients' assignments. Setting University medical centers. Participants 221 people aged 65 years old and older with major depression determined by SCID diagnosis and executive dysfunction as defined by a score of 33 or less on the Initiation-Perseveration Score of the Mattis Dementia Rating Scale or Stroop Interference Task score of 25 or less. Interventions 12 weekly sessions of Problem Solving Therapy or Supportive Therapy. Main Outcome Measures The suicide item of the Hamilton Depression Rating Scale (HDRS). Results Of the 221 participants, 61% reported suicidal ideation (SI). The ST group had a lower rate of improvement in SI after 12 weeks (44.6%) than did the PST group (60.4%, Fisher's exact test p = 0.031). Logistic regression showed significantly greater reductions in SI in elders who received PST at both 12 weeks (OR = .50, Z=-2.16, p = 0.031) and 36 weeks (OR=0.5, Z=-1.96, p=0.05) after treatment. Conclusion PST is a promising intervention for older adults who are at risk for suicide.

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Section: Discussionmentioning

confidence: 94%

Problem-Solving Therapy Reduces Suicidal Ideation In Depressed Older Adults with Executive Dysfunction

Gustavson

Alexopoulos

Niu

et al. 2016

The American Journal of Geriatric Psychiatry

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“…A more fine-grained interpretation of the studies described as measuring executive functioning above reveals older adults at risk for suicide are characterized by deficits in cognitive control (associated with high-lethality suicide attempts), deficits in decision-making (associated with lower lethality impulsive suicide attempts), and deficits in social cognition and social decision making (for a review, see Kiosses, Szanto, & Alexopoulos, 2014). One recent study using fMRI (Vanyukov, et al, 2014) found that greater impulsivity in social problem solving, as well as the presence of past unplanned suicide attempts, were associated with increased activation in the prefrontal cortex when viewing angry faces, suggesting that socioemotional stimuli are processed differently among older adults with impulsive suicide attempts.…”

Section: Cognition and Cognitive Impairmentmentioning

confidence: 99%

Issues in research on aging and suicide

Orden

Conwell

2015

Aging & Mental Health

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Late-life suicide is a complex clinical and public health problem. In this article, some of the key complexities inherent in studying late-life suicide are discussed in the service of promoting high quality late-life suicide prevention science. We discuss the following research issues: the relatively greater lethality of suicidal behavior in later life (compared to younger ages); the lack of data on whether thoughts of death in later life are indicators of suicide risk; the fact that older adults do not tend to seek specialty mental health care, necessitating moving research into primary care clinics and the community; the lack of theory-based research in late-life suicide; the unclear role of cognitive impairment; and the promise of taking a “patient centered” and “participatory research” approach to late-life suicide research efforts. We believe that these perspectives are too often not capitalized upon in research on suicide prevention with older adults and that voice of the older person could contribute much to our understanding of why older adults think about and act on suicidal thoughts, as well as the most acceptable ways to reach and intervene with those at risk.

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“…Conwell, Van Orden, and Caine (2011) reported in a review that depression had been identified in up to 97% of suicide deaths in older people. Meanwhile, loneliness and anxiety were found associated with suicidal ideation in older people with depression (Kiosses et al, 2014).…”

Section: The Impact Of Loneliness Anxiety and Depression In Older Pementioning

confidence: 98%

“…A literature review found that depression was the common mental disorder present in most suicides carried out by older people (Kiosses, Szanto, & Alexopoulos, 2014). Conwell, Van Orden, and Caine (2011) reported in a review that depression had been identified in up to 97% of suicide deaths in older people.…”

Section: The Impact Of Loneliness Anxiety and Depression In Older Pementioning

confidence: 99%

“…This can be due to reduced social interactions with significant others (Brownie & Horstmanshof, 2011), moving to an unfamiliar environment (Amzat & Jayawardena, 2016), and unexciting routines in RACFs (Zakaria et al, 2013) among other causes. Without intervention, these mental health problems may increase suicide rates (Kiosses et al, 2014) and have significant implications for older people's quality of life. Therefore, it is important to identify and adopt suitable interventions to reduce the impact of these mental health problems.…”

Section: Summary Of Thesismentioning

confidence: 99%

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