Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
Population Health Unit-"Salus In Apulia Study", National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy.
J Affect Disord. 2022 Dec 15;319:202-212. doi: 10.1016/j.jad.2022.09.046. Epub 2022 Sep 23.
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.
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.
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.
A relatively small number of older subjects with suicidal ideation (2.3 %); we did not distinguish between active and passive suicidal ideation.
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.
自杀意念与老年人群中生物心理社会预测因子之间可能存在关联，但目前尚不清楚。在基于人群的普利亚萨卢斯研究中，我们调查了 1252 名老年受试者中的生物标志物、社会人口统计学、心理病理学、炎症和代谢特征与自杀意念之间的关系。
使用哥伦比亚自杀严重程度评定量表的简短版本评估自杀意念。评估载脂蛋白 E (APOE) 基因型和炎症谱[白细胞介素 (IL)-6、肿瘤坏死因子 (TNF)-α、C 反应蛋白 (CRP)]。机器学习算法——随机森林 (RF)——选择与自杀意念相关的潜在生物心理社会因素。
有自杀意念的受试者占 2.32%，为女性、吸烟者和肥胖者，伴有多种合并症。在校正年龄、性别、教育程度和社会功能障碍后，逻辑回归分析显示，自杀意念与老年期抑郁症 (LLD) 相关（比值比：21.71，95%置信区间：9.22-51.14）。在全 RF 模型中，哮喘是自杀意念的最重要因素。在最终的 RF 模型中，教育程度、年龄、轻度认知障碍，其次是性别和整体认知，被认为是最重要的因素。在生物标志物中，在最终的 RF 模型中，IL-6 其次是 TNF-α、APOE ε4 等位基因的存在、CRP 和高密度脂蛋白胆固醇，对自杀意念的贡献最大。
有自杀意念的老年受试者人数相对较少（2.3%）；我们没有区分主动和被动自杀意念。
尽管 LLD 是自杀意念的一个强有力的决定因素，但在评估老年人群的自杀意念表型时，还应考虑其他非精神疾病因素，即血清炎症生物标志物、APOE ε4 等位基因和多种合并症。
