Aging Inmates Suicidal Ideation and Depression (Aging INSIDE) Study

 描述（由申请人提供）：美国监狱人口正在老龄化;越来越多的老年人被监禁，甚至更多的人正在“原地老化”。“年龄较大（>50岁）的囚犯是监狱人口中增长最快的部分，自杀率也是最高的。来自3所康涅狄格州监狱的146名老年囚犯（56%白色，28%黑人，9%西班牙裔，6%其他;年龄50-83）的试点研究数据支持这一应用程序表明，老年囚犯可能会经历抑郁症和自杀意念（SI）-每一个都是生活在“内部”和社区中的自杀的强有力预测因素。这些数据还表明，在混合年龄的囚犯样本中，与自杀风险增加相关的“传统”因素，如服刑时间或单牢房住房，对老年囚犯来说似乎不太相关。相反，“老年”考虑表明身体能力下降，包括日常生活活动（ADL）减少和身体脆弱或虚弱，可能会承担远 更重要的是识别有抑郁症和SI风险的老年囚犯。此外，监狱是一个独特的地方年龄。囚犯可能担心自己的安全，或因设施范围内的封锁而被取消特权。也有监狱特有的ADL（监狱ADL或PADL），包括爬上/爬下上铺和步行去吃饭。本研究的目标，老年囚犯的自杀意念和抑郁症（老化内部）研究，是要确定如何身体能力和监狱环境的独特需求可能会影响老年囚犯的可能性经历抑郁症和SI，重点是两个问题：老年因素，表明减少身体能力有用的识别老年囚犯在经历抑郁症和SI的风险增加？监狱特有的环境因素是否会随着时间的推移影响一个人的身体能力的变化，最终影响老年囚犯经历抑郁症和SI的可能性？老龄化内部将通过使用纵向研究设计来回答这些问题，并从10个康涅狄格州监狱招募250名年龄>50岁的被判刑囚犯，从补充来源（基于自我和表现的评估，医疗图表审查，基于罪犯的数据）收集基线和12个月的数据。在短期内，来自老龄化内部的研究结果将为老年囚犯的抑郁症和SI的风险评估和检测提供信息，这是一个高度欠研究和快速增长的高自杀率囚犯部分。从长远来看，所获得的知识将有助于确定最佳干预点（例如，PADL残疾或虚弱的发作）和预防的机会（例如，在老年囚犯中仍然存在可改变的风险因素。通过考虑独特的监狱环境对老年囚犯个人身体能力的影响，内部衰老将监狱中与自杀相关的研究推向更加个性化的风险降低和预防。最后，老龄化内部也是创新的，因为它侧重于老年囚犯;一个脆弱的和在很大程度上研究不足的人口集中在一个具有挑战性的环境进行研究。我们还包括一名伦理顾问，以确保保护研究参与者的权利。

 DESCRIPTION (provided by applicant): The U.S. prison population is aging; increasing numbers of older adults are being incarcerated and even more are aging "in place." Older (age >50) inmates are the fastest growing segment of the prison population and have the system's highest suicide rates. Pilot study data from 146 older inmates in 3 Connecticut state prisons (56% White, 28% Black, 9% Hispanic, 6% Other; ages 50-83) supporting this application indicate that older inmates are likely to experience depression and suicidal ideation (SI) - each a strong predictor of suicide among those living "on the inside" and in the community. These data also show that "conventional" factors associated with increased suicide risk in mixed-age inmate samples, such as time served or single-cell housing, appear less relevant for older inmates. Instead, "geriatric" considerations indicating diminished physical capacity, including decreased activities of daily living (ADLs) and physical vulnerability or frailty, may assume a far greater importance in identifying older inmates at risk of depression and SI. Furthermore, prison is a unique place to age. Inmates may fear for their safety or have privileges revoked due to facility-wide lockdowns. There are also ADLs specific to prison (prison ADLs or PADLs) including climbing on/off the top bunk and walking to chow. The goal of this research, the Aging Inmates' Suicidal Ideation and Depression (Aging INSIDE) Study, is to determine how physical capacity and unique demands of the prison environment may impact older inmates' likelihood of experiencing depression and SI, focusing on two questions: Are geriatric factors that indicate diminished physical capacity useful for identifying older inmates at increased risk of experiencing depression and SI? Do environmental factors unique to prison affect change in one's physical capabilities over time, ultimately impacting older inmates' likelihood of experiencing depression and SI? Aging INSIDE will answer these questions by using a longitudinal study design and by recruiting a sample of 250 sentenced inmates age >50 from 10 Connecticut state prisons, collecting data at baseline and 12 months from complementary sources (self- and performance-based assessments, medical chart review, offender-based data). In the short term, findings from Aging INSIDE will inform risk assessment and detection of depression and SI in older inmates, a highly understudied and rapidly growing segment of inmates with high suicide rates. In the longer term, knowledge gained will help determine an optimal point of intervention (e.g., onset of PADL disability or frailty) and opportunities for prevention (e.g., accommodations for disability) of still modifiable risk factors among older inmates. By considering the influence of the unique prison environment on older inmates' individual physical capacities, Aging INSIDE pushes the state of suicide-related research in prison towards more individualized risk reduction and prevention. Finally, Aging INSIDE is also innovative as it focuses on older inmates; a vulnerable and largely understudied population concentrated in a challenging setting for conducting research. We have included an ethical consultant to ensure protection of study participants' rights.