Prof. Norm O Rourke, Ph.D. Department of Public Health Ben-Gurion University of the Negev Be er Sheva, Israel

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1 Prof. Norm O Rourke, Ph.D. Department of Public Health Ben-Gurion University of the Negev Be er Sheva, Israel

2 Over recent decades, an large increase in the number of older adults with BD This is likely due to overall population aging as well as the efficacy of BD treatments today compared to generations past (e.g., pharmacotherapy). Unclear if same factors that predict self-harm by young with BD the same for older Cognitive loss and sleep disturbance known suicide risk factors with older adults o both of these are prevalent in later life with BD

3 years from BADAS (Bipolar Affective Disorder and older Adults) Study o recruited over 19 days using social media advertising targeted to adults with BD Global population of approximately 6.2 million English-speaking Facebook users o with bipolar disorder interests (e.g., members of online BD support networks) 140 women + 80 men, ranging from 50 to 81 years (M = 58.50, SD = 5.42) 36% Canada, 32% U.S., 16% U.K., 6% Australia, 5% Éire, 2% New Zealand o in total, participants from 10 countries provided responses; 94% were Caucasian o 35% married, 25% separated or divorced, 28% single, 11% partnered, 7% widowed

4 Participants completed years education on average (SD = 5.84, range 1-28) o of note, 22% of participants reported no paid work history 22% were on sick leave or receiving a disability pension, 13% were unemployed o only 14% were employed full-time, 6% worked part-time; 14% were retired o participants were largely under-employed relative to their education and qualifications 40% diagnosed with BD II, 32% diagnosed with BD NOS, and 20% with BD I o diagnosed years ago (SD = 10.68, range 6 weeks 45.5 years) o had.53 comorbid psychiatric conditions (SD = 1.04, range 0 5) o 2.4 prescribed psychotropic medications (SD = 1.55; range 0 12) o most indicated that they had made 1+ suicide attempt (53.2%)

5 Depressive S x, alcohol, cognitive failures, (low) life sat directly predict suicide ideation Depressive S x and cognitive failures indirect predictors o sleep disturbances, R x non-adherence, and duration of diagnosis also indirect predictors Life satisfaction strong (inverse) direct predictor of suicide ideation o of note, the combined direct + indirect effects of cognitive failures equal to life satisfaction o cognitive failures include perception, memory, and motor function errors Sleep disturbance mediates association between cognitive failures, depressive S x sleep disturbance not direct predictor of suicide ideation, yet indirect effect significant o greater than the combined effects of alcohol misuse o role of sleep disturbance is greater than R x non-adherence and duration of BD diagnosis Alcohol misuse and depressive S x sole direct predictors of R x non-adherence

6 Predictors of Suicide Ideation among Older Adults with BD

7 Direct and Indirect Predictors Suicide Ideation among Older Adults with BD

8 Inverse association between duration of D x and depressive S x, suicide ideation o with younger adults, earlier age of BD onset a suicide risk factor Have older adults with BD have acclimated to their D x and symptomatology? o or have they have devised more effective coping strategies over time? As with younger adults with BD: o alcohol misuse, R x non-adherence, depressive S x predict suicide ideation Sleep disturbance and cognitive failures significant predictors of suicide ideation o both directly and indirectly Future research should examine the role of substances in addition to alcohol o illicit substance use is common with BD

9 Thank You Support for the BADAS study provided by the Canadian Institutes of Health Research, Institute of Aging Monument to the Negev Brigade, Be er Sheva Israel

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