Longitudinal associations between serum cholesterol levels and suicidal ideation in an older Korean population

Introduction: Relationships between low total cholesterol levels and suicidality have been reported but there has been little investigation of this issue in older age groups. This study aimed to investigate longitudinal associations between serum lipid levels and suicidal ideation in an older population. Methods: 732 community dwelling elderly aged 65 or over were evaluated at baseline. Of 639 did not have suicidal ideation at baseline, 579 (90.6%) were followed two years later. Prevalence and incidence of suicidal ideation within the previous one month was ascertained. Serum levels of total-, high density lipoprotein (HDL)-, low density lipoprotein (LDL) - cholesterol, and triglycerides were assayed at both baseline and follow-up. Baseline data on potential covariates including sociodemographic characteristics, life stress, social support, pain, alcohol drinking, depressive symptoms, cognitive function, and disability were gathered. Results: Both higher and lower total and LDL cholesterol levels at baseline and a decline in total cholesterol levels over the follow-up period predicted an increased incidence of suicidal ideation at follow-up independent of sociodemographic and clinical covariates. Significant cross-sectional associations were found between suicidal ideation at baseline and higher total and LDL cholesterol levels. Limitations: Suicidal ideation was the outcome of the study. Therefore generalizability should be considered. Conclusions: These results support a role of dyslipidemia in the etiology of late-life suicidal ideation. Not only low but also higher cholesterol levels predicted the incidence of suicidal ideation in elders. Lipid sub-fraction assays might be informative in this respect at least in older populations. (C) 2013 Elsevier B.V. All rights reserved,