B – 79 Does Onset of Depression-Related Cognitive Impairment Influence Suicidality in Middle-aged and Older adults: A Scoping Review

Objective Major Depressive Disorder (MDD) often involves depression-related cognitive impairment (DRCI) and is a strong diagnostic predictor of suicide risk in older adults. This scoping review integrates research on DRCI (cognitive inhibition, working memory, and decision-making) and age of depression onset in middle aged and older adults with MDD who attempt suicide to clarify future research directions. Method Searches (e.g., “MDD,” “aging,” “depression onset,” “cognitive inhibition,” “working memory,” “decision-making”) across Pubmed and PsycNFO yielded studies incorporating self-reported suicidal behavior and DRCI related neuropsychological measures. 11 studies (spanning 2001-2019) were extracted that included onset of MDD, suicidal behavior, and DRCI factors of: a) cognitive inhibition, b) working memory, and c) decision making. Studies limited to neuroimaging outcome measures and other forms of executive functioning components were excluded. Results Cross-sectional self-report and neuropsychological results reflect greater DRCI in participants who attempted suicide compared to no-suicide attempt groups. Despite research suggesting different cognitive profiles of age of MDD onset and suicide attempt, this review found few studies of significant differences in DRCI between early and late onset MDD and suicidal behavior in middle aged and older adults. Conclusion Results suggest DRCI differences across suicide attempt status but not across age of onset of depression. Comparisons across studies were limited by varying measures of DRCI, reliance on participants’ retrospective recall when determining onset of depression, and commonalities in authorship and samples. Future studies must incorporate more rigorous methods of assessing depression onset to identify cognitive risk factors for suicidality in middle-aged and older adults.