Pathways from social disconnection to suicidal ideation in later life

从社交脱节到晚年自杀意念的途径

• 批准号: 10592590
• 负责人: Mark Ward
• 金额: $ 7.08万
• 依托单位: TRINITY COLLEGE DUBLIN
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10592590
• 关键词: Address; Adult; Age; Aging; Alcohol consumption; Anxiety; Behavioral; Biological Markers; Biology of Aging; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Clinic; Clinical; Clinical Markers; Collaborations; Communities; Complex; Data; Data Analytics; Early identification; Economics; Elderly; Europe; Exhibits; Feeling hopeless; Feeling suicidal; Future; Goals; Growth; Health; Heart Rate; Hydrocortisone; Immune; Impulsivity; Individual; International; Intervention; Ireland; Knowledge; Link; Loneliness; Longitudinal Studies; Mental Depression; Mental Health; Modeling; National Institute of Mental Health; Nature; Neurosecretory Systems; Parasympathetic Nervous System; Participant; Pathway interactions; Perception; Persons; Physical activity; Physiological; Play; Process; Prospective Studies; Prospective cohort; Prospective, cohort study; Public Health; Questionnaires; Reporting; Research; Research Domain Criteria; Research Personnel; Risk; Risk Factors; Role; Sleep; Smoking; Social Environment; Social isolation; Stress; Suicide; Suicide attempt; Surveys; System; Techniques; Testing; Thinking; Time; Training; Uranium; Woman; aged; cardiometabolism; cohort; community setting; experience; field study; geriatric depression; health assessment; health care settings; health definition; high risk; ideation; immune function; improved; inflammatory marker; multidisciplinary; physical conditioning; prevent; protective factors; psychologic; response; social; social integration; social relationships; sociodemographics; sociologist; suicidal behavior; suicidal morbidity; suicidal risk; suicide rate; theories

ABSTRACT Suicide deaths and social disconnection among older adults are increasingly serious public health concerns. A 'Wish To Die' (WTD) is an indicator of passive suicide ideation which refers to thoughts of one’s own death, that one would be better off dead, or wishing for one’s death. The association between social disconnection and suicide is widely recognised and social disconnection has been shown to be associated with an increased likelihood of WTD. Importantly, social disconnection is a multi-faceted construct and both the quantity (social isolation) and quality (loneliness) of people’s social relationships are strongly related to both suicide ideation and subsequent suicide attempts. While this association is well-established, the mechanistic pathways to explain the association are less well understood. The main putative mechanisms proposed are: behavioral (sleep, physical activity, smoking, alcohol consumption), psychological (depression, anxiety, and ageing perceptions), and physiological (neuroendocrine, immune function, and cardiometabolic). This study leverages data from The Irish Longitudinal Study on Ageing (TILDA) to identify the pathways that explain the association between social disconnection and passive suicidal ideation. TILDA is a large, nationally representative, prospective cohort study that examines the social, economic and health circumstances of 8,500+ community-dwelling adults aged 50 years and older in Ireland. TILDA data have been collected every two years since 2009 and includes both survey data (CAPI and SCQ) and a comprehensive clinic-based health assessment. Detailed biomarker data are available from these health assessments and include markers from the neuroendocrine, immune, cardiometabolic, and parasympathetic systems. Using this longitudinal data, the study aims to: (1) Identify who is at highest risk of social disconnection and WTD among older adults as well as when individuals are most at risk; (2) Examine the nature of the associations between social disconnection and WTD, including strength, temporality, and directionality, among older adults; (3) Identify mechanistic pathways that explain the association between social disconnection and WTD. To address these aims, four waves of survey and two waves of biomarker data will be investigated and advanced longitudinal statistical techniques (GLMM, latent growth curve, latent class growth analysis, and SEM path analysis) will be applied. Given the complex nature of this study, we have assembled an outstanding multi-disciplinary team of clinical and academic researchers with expertise in each of the constituent parts of the project. By establishing the causal pathways between social disconnection and WTD, study results will identify important risk and protective factors for suicidal ideation that are amenable to intervention. In doing so, the study will inform effective clinical and community-based interventions by which the train of thoughts leading to active suicidal ideation can be stopped before individuals progress to active ideation and suicidal behavior.

抽象的 老年人的自杀死亡和社会脱节越来越严重。一个愿望 死亡'（WTD）是被动自杀想法的指标，它是指一个人死的想法，一个人会 更好地死了，或者希望死。社会断开与自杀之间的关联广泛 已公认和社会断开连接已被证明与WTD的可能性增加有关。 重要的是，社会脱节是一种多方面的结构，既有数量（社会隔离）和质量 （孤独）人们的社会关系与自杀念头和随后的自杀密切相关 尝试。虽然这种关联是完善的，但解释该关联的机械途径却不太好 理解。提出的主要推定机制是：行为（睡眠，体育锻炼，吸烟，酒精 消费），心理（抑郁，动画和衰老的看法）和身体（神经内分泌， 免疫功能和心脏代谢）。 这项研究利用爱尔兰纵向研究（TILDA）的数据来确定解释的途径 社会脱节与被动自杀思想之间的关联。蒂尔达是一个大型国家 代表，前瞻性队列研究，研究了8,500多个的社会，经济和健康状况 爱尔兰50岁及以上的社区成年人。从那以后每两年收集一次Tilda数据 2009年，包括调查数据（CAPI和SCQ）和综合诊所的健康评估。详细的 这些健康评估可从生物标志物数据获得，包括神经内分泌，免疫， 心脏代谢和副交感神经系统。 使用此纵向数据，该研究的目的是：（1）确定谁处于社会脱节和WTD的最高风险 在老年人以及个人最有风险的何时； （2）检查关联之间的性质 社会脱节和WTD，包括老年人的力量，暂时性和方向性； （3）识别 解释社会断开与WTD之间关联的机械途径。为了解决这些目标， 将研究四波调查和两个生物标志物数据波和晚期纵向统计 将应用技术（GLMM，潜在生长曲线，潜在类增长分析和SEM路径分析）。 鉴于这项研究的复杂性，我们组建了一个出色的临床多学科团队 在项目的每个组成部分中拥有专家的学术研究人员。通过建立因果关系 社会断开与WTD之间的途径，研究结果将确定重要的风险和保护因素 自杀的想法可以接受干预。为此，该研究将为有效的临床和 基于社区的干预措施，可以阻止导致积极自杀想法的思想列车 在个人发展为主动的构想和自杀行为之前。