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Cited 2 time in webofscience Cited 4 time in scopus
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Executive dysfunction and risk of suicide in older adults: a population-based prospective cohort study

Authors
Oh, Dae JongHan, Ji WonBae, Jong BinKim, Tae HuiKwak, Kyung PhilKim, Bong JoKim, Shin GyeomKim, Jeong LanMoon, Seok WooPark, Joon HyukRyu, Seung-HoYoun, Jong ChulLee, Dong YoungLee, Dong WooLee, Seok BumLee, Jung JaeJhoo, Jin HyeongKim, Ki Woong
Issue Date
May-2021
Publisher
BMJ PUBLISHING GROUP
Citation
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, v.92, no.5, pp.528 - 533
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
Volume
92
Number
5
Start Page
528
End Page
533
URI
https://scholarworks.bwise.kr/gnu/handle/sw.gnu/3790
DOI
10.1136/jnnp-2020-324390
ISSN
0022-3050
Abstract
Objective It is uncertain what factors increases the risk of suicide in older adults without depression, and it is unknown whether executive dysfunction (ED) is one of those factors. We aimed to examine the effect of ED on the risk of suicide in non-demented older adults without depression. Methods In an ongoing population-based prospective cohort of Korean older adults, we identified suicide using the National Mortality Database and suicidal ideation or attempt (SIA) based on the Korean version of the Mini International Neuropsychiatric Interview. We defined ED as performing below -1.5 SD of age-adjusted, gender-adjusted and education-adjusted norms in any of following tests: Frontal Assessment Battery, Trail Making Test A, Digit Span Test or Verbal Fluency Test. Results The mean age of the 4791 participants at baseline was 69.7 (SD 6.4) years, and 57.1% of them were women (mean follow-up duration=4.9 years). ED at baseline increased the risk of suicide by about seven times (HR 7.20, 95% CI 1.84 to 28.12, p=0.005) but did not change the risk of SIA. However, cognitive impairment without ED did not change the risks of suicide and SIA. In participants with ED, being aged 75 years or above, living alone, and having a low socioeconomic status were associated with the risk of suicide. Conclusion ED is a strong risk factor of late life suicide independent from depression, particularly in very old adults living in disadvantaged environments.
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