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October 5, 2022

7x higher suicide risk: The high toll of early dementia diagnoses

Daily Briefing

    A study published Monday in JAMA Neurology found that recently diagnosed dementia patients under the age of 65 faced a suicide risk nearly seven times higher than patients without dementia, Judy George writes for MedPage Today.

    Study details and key findings

    For the study, researchers analyzed medical databases and death records for 594,674 people in England from 2001 to 2019. They looked at records from England's Office for National Statistics that had a death classified as suicide or open verdict. The researchers matched as many as 40 control participants with each suicide case. Then, they adjusted their findings for sex and age at suicide or index date.

    Of the 594,674 participants, 580,159 were controls, and 14,515 died by suicide. Among the control group, the median age at death was 81.6, and 50% were men. Among the participants who died by suicide, the median age at death was 47.4, and 74.8% were men.

    After a median follow up of 2.3 years, 4,940 patients were diagnosed with dementia. Among those patients, 1.9% of people with dementia died by suicide—a total of 95 participants.

    Notably, 61.1% of dementia patients who died by suicide were men. Their median age at the time of diagnosis was 75.1, and their age at death was 79.5.

    According to study author Danah Alothman of the University of Nottingham and colleagues, suicide risk increased in the three months following a dementia diagnosis. For people under the age of 65, suicide risk in the three months following a diagnosis was 6.69 times higher than in patients without dementia.

    However, suicide risk among younger people was elevated at any point after a dementia diagnosis. In addition, people with psychiatric comorbidities faced a 1.52 times higher risk of suicide at any age or point in time.

    Commentary

    According to co-author Charles Marshall of Wolfson Institute of Population Health at Queen Mary University of London, these findings illustrate that "[i]mproving access to a dementia diagnosis is an important healthcare priority."

    "However, a dementia diagnosis can be devastating, and our work shows that we also need to ensure that services have the resources to provide appropriate support after a diagnosis is given," Marshall noted.

    Ultimately, suicide deaths are more common among people who have been diagnosed with any type of neurologic disorder. In an analysis of Medicare patients, researchers found that death by suicide increased after patients were diagnosed with Alzheimer's or dementia.

    In this study, the highest risk occurred in the 90 days following a diagnosis among people 65 to 74 years old. While other research has looked at suicide risk following a dementia diagnosis, Alothman and colleagues noted that suicide risk among people younger than age 65 has not been evaluated.

    "Given the high risk of both suicide attempt and suicide death associated with a recent dementia diagnosis, 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," the researchers wrote. (George, MedPage Today, 10/3; Alothman et al., JAMA Neurology, 10/3)

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