Childhood cognitive ability and self-harm and suicide in later life

• Published in: SSM - population health 2024-03, Vol.25, p.101592, Article 101592
• Main Authors: Iveson, Matthew H., Ball, Emily L., Whalley, Heather C., Deary, Ian J., Cox, Simon R., Batty, G. David, John, Ann, McIntosh, Andrew M.
• Format: Article
• Language: English
• Subjects: Cognitive ability; Data linkage; Epidemiology; Older age; Self-harm; Suicide
• ISSN: 2352-8273; 2352-8273
• DOI: 10.1016/j.ssmph.2023.101592

Self-harm and suicide remain prevalent in later life. For younger adults, higher early-life cognitive ability appears to predict lower self-harm and suicide risk. Comparatively little is known about these associations among middle-aged and older adults. This study examined the association between childhood (age 11) cognitive ability and self-harm and suicide risk among a Scotland-wide cohort (N = 53037), using hospital admission and mortality records to follow individuals from age 34 to 85. Multistate models examined the association between childhood cognitive ability and transitions between unaffected, self-harm, and then suicide or non-suicide death. After adjusting for childhood and adulthood socioeconomic conditions, higher childhood cognitive ability was significantly associated with reduced risk of self-harm among both males (451 events; HR = 0.90, 95% CI [0.82, 0.99]) and females (516 events; HR = 0.89, 95% CI [0.81, 0.98]). Childhood cognitive ability was not significantly associated with suicide risk among those with (Male: 16 events, HR = 1.05, 95% CI [0.61, 1.80]; Female: 13 events, HR = 1.08, 95% CI [0.55, 2.15]) or without self-harm events (Male: 118 events, HR = 1.17, 95% CI [0.84, 1.63]; Female: 31 events, HR = 1.30, 95% CI [0.70, 2.41]). The study only includes self-harm events that result in a hospital admission and does not account for self-harm prior to follow-up. This extends work on cognitive ability and mental health, demonstrating that these associations can span the life course and into middle and older age. •Examines associations with cognitive ability measured in childhood (age 11 years).•Uses a large nationwide sample of older adults born around 1936 (N = 53037).•Uses electronic health records to trace self-harm and suicide from age 34 to 85.•Self-harm and suicide were relatively rare among older adults.•Higher age-11 cognition was associated with lower risk of self-harm but not suicide.