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是日益严重的公共卫生问题。 “去死”（WTD）是被动自杀意念的一个指标，指的是一个人自己死亡的想法，即一个人会 死掉会更好，或者希望自己死掉 社交脱节与自杀之间存在着广泛的联系。 公认的和社会脱节已被证明与 WTD 的可能性增加有关。 重要的是，社会脱节是一个多方面的建构，无论是数量（社会孤立）还是质量 人们社会关系的（孤独）与自杀意念和随后的自杀密切相关 虽然这种关联已经很确定，但解释这种关联的机制途径还不太清楚。 所提出的主要假定机制是：行为（睡眠、体力活动、吸烟、饮酒）。 消费）、心理（抑郁、焦虑和衰老认知）和生理（神经内分泌、 免疫功能和心脏代谢）。 这项研究利用爱尔兰老龄化纵向研究 (TILDA) 的数据来确定解释的途径 TILDA 与社会脱节和被动自杀意念之间的关联是全国性的。 具有代表性的前瞻性队列研究，调查了超过 8,500 人的社会、经济和健康状况 自此以后，爱尔兰 50 岁及以上社区居民的数据每两年收集一次。 2009 年，包括调查数据（CAPI 和 SCQ）和基于临床的综合详细健康评估。 生物标志物数据可从这些健康评估中获得，包括来自神经内分泌、免疫、 心脏代谢和副交感系统。 利用这些纵向数据，该研究旨在：(1) 确定谁最有可能发生社交脱节和 WTD (2) 检验之间关联的性质 (3) 识别老年人中的社会脱节和 WTD，包括强度、暂时性和方向性； 解释社会脱节与 WTD 之间关联的机制途径 为了实现这些目标， 将调查四波调查和两波生物标志物数据并进行高级纵向统计 将应用技术（GLMM、潜在增长曲线、潜在类别增长分析和 SEM 路径分析）。 鉴于这项研究的复杂性，我们组建了一支由临床和临床专家组成的优秀多学科团队 具有项目每个组成部分专业知识的学术研究人员通过建立因果关系。 社会脱节和 WTD 之间的途径，研究结果将确定重要的风险和保护因素 在此过程中，该研究将为有效的临床和治疗提供信息。 基于社区的干预措施，可以阻止导致主动自杀意念的思绪 在个体发展出积极的意念和自杀行为之前。