Brain Volume Reductions and Relationship With Depression and Cognitive Functioning in Suicide in Older Adults: A...

Area of Science:

• Neuroscience
• Gerontology
• Psychiatry

Background:

• Depression with cognitive impairment in older adults can signal early dementia and increase suicide risk.
• Neuroanatomical correlates of these impairments, especially longitudinal changes, remain largely unknown.

Purpose of the Study:

• To investigate the neuroanatomical differences in brain volumes associated with a history of suicide attempts, depression, and cognitive impairment in older adults.
• To examine longitudinal changes in brain volumes in relation to these factors.

Main Methods:

• Structural magnetic resonance imaging (MRI) scans were obtained from 153 older adults with a history of suicide attempts, depression, or no psychiatric history.
• Bayesian multilevel modeling was used to analyze cross-sectional and prospective changes in brain volumes, controlling for suicide attempt history, depression severity, and cognitive functioning.
• 51 participants underwent repeated MRI scans to assess longitudinal changes.

Main Results:

• A history of suicide attempts and impaired executive functioning were linked to reduced volumes in temporal, parietal, occipital regions, and the hippocampus.
• Depression, particularly current episode severity, was associated with reductions in frontal and subcortical brain volumes.
• Cognitive impairment characteristic of cortical dementia predicted medial temporal volume reduction.

Conclusions:

• Suicidal behavior, depression, and dementia-related cognitive decline in older adults are associated with reduced brain volumes in distinct but converging regions, notably the hippocampus.
• The hippocampus may serve as a central point for co-occurring changes related to depression, suicide risk, and neurodegeneration.
• These findings suggest distinct neurocognitive deficits in older adults at risk for late-life suicide and emphasize the importance of understanding hippocampal structure for risk prediction and treatment development.