Arthur Simen, M.D., Ph.D.

Arthur Simen, M.D., Ph.D., Yale University

Standard Research Grant (2009): $75,000

Prefrontal and Genetic Determinants of Suicidality in the Elderly with Cardiac Disease

Abstract: Aging and medical illness are important risk factors for the development of suicide and suicidal behaviors and thinking. Suicide risk is higher among the elderly than any other age group. Aging is associated with multiple psychosocial and biological stressors including medical illness, as well as changes in cognitive function that is governed by the prefrontal cortex. Studies to date have established the importance of poor neurocognitive function and medical illness in increasing risk for suicide in the elderly, but the causal mechanism remains unclear. This research program will test for the individual differences in suicidal ideation in the elderly which are due in part to individual differences in cognitive function, and that adaptive coping and hopelessness mediate the relationship between cognitive function and suicidal ideation. The research will examine the individual differences in prefrontal cortex function which are largely determined by genetic variation in HCN1, a gene involved in determining prefrontal cortex function, will be related to prefrontal cortex performance at the time of the first assessments in patients and their spouses. Prefrontal cortex cognitive function will be assessed using the CANTABeclipse program, a very well characterized and standardized computerized neuropsychological test package. This research will be done on a particularly high risk population, elderly patients with acute coronary syndrome (ACS) and their spouses. This work will serve as the foundation of a translational research program examining the multifactorial etiology of suicidal ideation in the elderly.