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Sunday, December 4, 2022

Risk of Suicide After Dementia Diagnosis

Alothman D, Card T, et al.
JAMA Neurology
Published online October 03, 2022.


Importance  Patients with dementia may be at an increased suicide risk. Identifying groups at greatest risk of suicide would support targeted risk reduction efforts by clinical dementia services.

Objectives  To examine the association between a dementia diagnosis and suicide risk in the general population and to identify high-risk subgroups.

Design, Setting, and Participants  This was a population-based case-control study in England conducted from January 1, 2001, through December 31, 2019. Data were obtained from multiple linked electronic records from primary care, secondary care, and the Office for National Statistics. Included participants were all patients 15 years or older and registered in the Office for National Statistics in England with a death coded as suicide or open verdict from 2001 to 2019. Up to 40 live control participants per suicide case were randomly matched on primary care practice and suicide date.

Exposures  Patients with codes referring to a dementia diagnosis were identified in primary care and secondary care databases.

Main Outcomes and Measures  Odds ratios (ORs) were estimated using conditional logistic regression and adjusted for sex and age at suicide/index date.

Conclusions and Relevance  Diagnostic and management services for dementia, in both primary and secondary care settings, should target suicide risk assessment to the identified high-risk groups.

Key Points

Question  Is there an association between dementia diagnosis and a higher risk of suicide?

Findings  In this nationally representative case-control study including 594, 674 persons in England from 2001 through 2019, dementia was found to be associated with increased risk of suicide in specific patient subgroups: those diagnosed before age 65 years (particularly in the 3-month postdiagnostic period), those in the first 3 months after diagnosis, and those with known psychiatric comorbidities.

Meaning  Given the current efforts to improve rates of dementia diagnosis, these findings emphasize the importance of concurrent implementation of suicide risk assessment for the identified high-risk groups.