# Decision Processes of Late-Life Suicide

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $356,021

## Abstract

We are requesting a One-Year Administrative Supplement to the NIMH R01 MH085651-10 Decision
Processes in Late-Life Suicide. The parent grant is a 5-year case-control longitudinal study of decision-
making in older adults who have attempted suicide, with a special focus on those who have carried out
medically serious (high-lethality) suicide attempts. Our overarching aim is to understand decision
processes that may contribute to suicidal behavior in old age. Neurocognitive and decision-related factors
may play a particularly salient role in late-life suicide due to age-related cognitive decline. Older adults
have a higher risk of suicide, and that risk is even further elevated by those with a diagnosis of dementia,
especially in the early stages of dementia. We have recently reported that there is a subgroup of older
people characterized by high-lethality suicidal behavior, late-onset depression, marked cognitive decline,
and higher risk of future suicide attempts, possibly representing a subtype of people with prodromal
dementia that have a very high risk of suicide. In this supplement, we propose to investigate how
neurodegeneration in the locus coeruleus, entorhinal cortex, and hippocampus, representative of
neurodegeneration that occurs in early Alzheimer’s, relates to deficits in decision-making and to suicide
attempts in a sample of 135 older adults. We propose to perform complex behavioral tasks that mimic real-
life decisions. As indicators of Alzheimer’s-relevant neurodegeneration, we will analyze archival and newly-
obtained structural MRI data to assess hippocampal and entorhinal cortex atrophy and will acquire (in a
subgroup) neuromelanin-sensitive turbo spin echo scans to measure locus coeruleus signal intensity. We
hypothesize that entorhinal cortex-hippocampus atrophy and reduced locus coeruleus function predict
impaired decision making due to poorer ability to use information about task structure and reduced
exploration of available options. We further hypothesize that Alzheimer’s-relevant dysfunction in exploration
and learning task structure, as measured from task-derived computational parameters, will be greater in
depressed elderly who are at high risk for suicide (those with a history of suicide attempt and current
severe suicidal ideation) relative to depressed elders with low suicide risk. The Supplement will take
advantage of a well-characterized sample of depressed older adults participating in the parent grant and
will enrich it with individuals with prodromal Alzheimer’s disease, taking advantage of the Pittsburgh
Alzheimer’s Disease Research Center’s registry. The investigators will contribute their complementary
expertise in suicide risk factors, decision making, reinforcement learning, computational modeling,
neuroimaging, and dementia.

## Key facts

- **NIH application ID:** 10119531
- **Project number:** 3R01MH085651-11S1
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Katalin Szanto
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $356,021
- **Award type:** 3
- **Project period:** 2010-09-15 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10119531

## Citation

> US National Institutes of Health, RePORTER application 10119531, Decision Processes of Late-Life Suicide (3R01MH085651-11S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10119531. Licensed CC0.

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