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Using latent class growth modeling to examine cognitive predictors of suicidal ideation in the elderly

Kasckow, John (2014) Using latent class growth modeling to examine cognitive predictors of suicidal ideation in the elderly. Master's Thesis, University of Pittsburgh. (Unpublished)

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Late life suicide is a serious public health concern. Suicide rates peak in individuals aged 65 or older. Because individuals 65 or older will comprise 20% of the population by 2039, late life suicide is expected to be a growing public health problem. Recent cross sectional studies suggest that deficits in frontal executive functioning, memory and attention are associated with suicidal ideation in the elderly. Our current study is a secondary analysis of data from a clinical trial entitled “Incomplete Response in Late Life Depression: Getting to Remission”. Individuals with major depression received venlafaxine XR monotherapy for depression and were followed repeatedly for up to 16 weeks. We used latent class growth modeling to classify groups of individuals aged > 60 based on trajectories of suicidal ideation. We controlled for time dependent variables (depression and antidepressant doses) and baseline demographics. The optimal model classified individuals into three groups with linear or quadratic trajectories of suicidal ideation. We also ran various analyses using different link functions to find the link that was most appropriate for our data (logistic, censored normal or zero inflated Poisson). After trajectory group membership was determined, we examined whether cognitive dysfunction predicted suicidal ideation trajectory membership using multinomial logistic regression. Using the zero inflated Poisson link latent trajectory model, we determined that having a better score on the Trails B frontal lobe measure was statistically significantly associated with individuals having higher levels of suicidal ideation; however, this association was no longer significant when a multivariable model was used. No statistically significant associations were observed with the other frontal lobe measures, i.e., Trails B/A, Stroop 3 and Stroop 4. In addition, neither individual subscale scores nor total scores from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were associated with individuals with having higher trajectories of suicidal ideation. The present study is the first to our knowledge that examines how cognitive status is associated with long-term trajectories of suicidal symptoms in depressed elderly adults.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Kasckow, Johnjwk21@pitt.eduJWK21
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorYouk, Adayouk@pitt.eduYOUK
Committee MemberDew, Mary Amandadewma@upmc.eduDEW1
Committee Memberanderson,‎
Committee MemberReynolds, CharlesReynoldsCF@upmc.eduCHIPR
Date: 27 June 2014
Date Type: Publication
Defense Date: 31 January 2014
Approval Date: 27 June 2014
Submission Date: 30 March 2014
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 88
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: latent class growth modeling; suicide; elderly; depression
Date Deposited: 27 Jun 2014 21:40
Last Modified: 01 May 2019 05:15


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