SUICIDAL THINKING IN COMMUNITY RESIDENTS OVER 80

Objective. Main objective: to study the relationship between suicidal thinking and both cognitive impairment and depression. Design. Random sample selected for interview, all of whom were a cohort in a pre-exis ting epidemiological study of dementia. Setting. Community residents. Patients and other participants. Participants aged over 81. Study excl uded the following: moved out of area/died/too frail/severe communicat ion difficulties/refused interview, refusal by GP/family/carers. 300 n ames selected at random from database. 170 eligible participants appro ached; 31 refused, 125 interviewed. 125 informants approached for inte rview; 118 interviewed. Main outcome measures. CAMDEX, 15-item Geriatr ic Depression Scale (GDS), and Scale for Suicidal Ideation (SSI) (incl uding informant versions of latter 2 scales). Results. 9 people showed suicidal thinking, all women; 6 had clinical evidence of cardiovascul ar/cerebrovascular disease. Those with suicidal thinking showed higher CAMDEX depression scores, weaker strength of the wish to go on living , higher rates of expressing wish to die and higher rates of depressiv e illness and mixed DAT/multi-infarct dementia as primary psychiatric diagnoses. No significant associations between suicidal thinking and G DS scores, Alzheimer-type dementia alone, awareness of memory difficul ties or severity of dementia. Conclusions. Results show association be tween suicidal thinking and both depression and mixed DAT/multi-infarc t dementia, but do not support an association between suicidal thinkin g and awareness of memory problems/severity of dementia. Given the met hodological limitations, the significance of the results should be vie wed with caution. Further exploration of the role of cerebrovascular d isease in depressive disorder is suggested. ((C) 1997 by John Wiley & Sons, Ltd.)