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Dementia Diagnosis Associated With Increased Suicide Risk in Certain Subgroups
Dementia diagnosis is associated with an increased risk of suicide in patients recently diagnosed, under 65 years old, and patients with psychiatric comorbidities, according to a study published in JAMA Neurology.
“These results have important implications for dementia screening and management and for suicide prevention, both within specialist dementia services and primary care settings," lead author Danah Alothman, BMBCh, MPH, University of Nottingham, England, and co-authors noted.
As for why these particular subgroups are more affected than others, researchers surmised that the “relative rarity and unexpectedness of the diagnosis” in younger patients can make accepting and adjusting to the condition more difficult. “Additionally, younger patients, more than older patients, with dementia may forecast worse outcomes of their disorder in relation to their life expectancy; they may perceive that they will live long enough to progressively experience the most severe form of the disorder,” researchers noted.
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Researchers also hypothesized that suicide risk increased in patients following a recent diagnosis because that is the stage of the disorder where patients may be aware of the deficit and still have the capabilities to plan and execute a suicide.
Researchers analyzed English population data from January 1, 2001, to December 31, 2019, with dementia diagnosis identification from primary and secondary care databases. All participants were at least 15 years old and registered in the Office for National Statistics in England with a suicide death or open verdict from 2001 to 2019. Per suicide case, 40 living control participants were included.
Of the 594,674 patients, 14,515 died by suicide and 95 of those suicide deaths had a recorded diagnosis of dementia. Although there was no overall association made between dementia diagnosis and suicide risk, researchers did find a significant increase in risk with patients diagnosed before age 65, in the first 3 months following diagnosis, and those with an accompanying psychiatric comorbidity. For those diagnosed under 65 years old and in the 3 months following diagnosis, suicide risk was found to be 6.69 times higher than in patients without dementia.
A study published in Alzheimer’s & Dementia in 2021 found a similar risk in patients 3 months (90 days) after diagnosis as well as an increased risk in those with rural residence and with recent mental health, substance use, or chronic pain conditions.
“We suggest that the current efforts for prompt dementia diagnosis should be accompanied by suicide risk assessment measures focused on the period immediately after diagnosis and in those with young-onset dementia,” researchers concluded.
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