Suicidal ideation in dementia: Associations with neuropsychiatric symptoms and subtype diagnosis

TY - JOUR

T1 - Suicidal ideation in dementia

T2 - Associations with neuropsychiatric symptoms and subtype diagnosis

AU - Naismith, Hamish

AU - Howard, Robert

AU - Stewart, Robert

AU - Pitman, Alexandra

AU - Mueller, Christoph

N1 - Funding Information: C. Mueller and R. Stewart are part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, which also supports the development and maintenance of the Biomedical Research Centre Case Register. R. Howard is supported by the NIHR UCLH BRC. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR, or the Department of Health and Social Care. Acknowledgements Funding Information: R. Stewart has received funding from Janssen, GSK, and Takeda outside the submitted work. Other authors have nothing to disclose. Publisher Copyright: ©

PY - 2022/4/25

Y1 - 2022/4/25

N2 - ABSTRACT Objectives: To investigate factors associated with suicidal ideation (SI) around the time of dementia diagnosis. We hypothesised relatively preserved cognition, co-occurring physical and psychiatric disorders, functional impairments, and dementia diagnosis subtype would be associated with a higher risk of SI. Design: Cross-sectional study using routinely collected electronic mental healthcare records. Setting: National Health Service secondary mental healthcare services in South London, UK, serving a population of over 1.36 million residents. Participants: Patients who received a diagnosis of dementia (Alzheimer's, vascular, mixed Alzheimer's/vascular, or dementia with Lewy bodies) between 1 Nov 2007-31 Oct 2021: 18,252 people were identified during the observation period. Measurements: A natural language processing algorithm was used to identify recorded clinician recording of SI around the time of dementia diagnosis. Sociodemographic and clinical characteristics were also measured around the time of diagnosis. We compared people diagnosed with non-Alzheimer's dementia to those with Alzheimer's and used statistical models to adjust for putative confounders. Results: 15.1% of patients had recorded SI, which was more common in dementia with Lewy bodies compared to other dementia diagnoses studied. After adjusting for sociodemographic and clinical factors, SI was more frequent in those with depression and dementia with Lewy bodies and less common in those with impaired activities of daily living and in vascular dementia. Agitated behavior and hallucinations were not associated with SI in the final model. Conclusions: Our findings highlight the importance of identifying and treating depressive symptoms in people with dementia and the need for further research into under-researched dementia subtypes.

AB - ABSTRACT Objectives: To investigate factors associated with suicidal ideation (SI) around the time of dementia diagnosis. We hypothesised relatively preserved cognition, co-occurring physical and psychiatric disorders, functional impairments, and dementia diagnosis subtype would be associated with a higher risk of SI. Design: Cross-sectional study using routinely collected electronic mental healthcare records. Setting: National Health Service secondary mental healthcare services in South London, UK, serving a population of over 1.36 million residents. Participants: Patients who received a diagnosis of dementia (Alzheimer's, vascular, mixed Alzheimer's/vascular, or dementia with Lewy bodies) between 1 Nov 2007-31 Oct 2021: 18,252 people were identified during the observation period. Measurements: A natural language processing algorithm was used to identify recorded clinician recording of SI around the time of dementia diagnosis. Sociodemographic and clinical characteristics were also measured around the time of diagnosis. We compared people diagnosed with non-Alzheimer's dementia to those with Alzheimer's and used statistical models to adjust for putative confounders. Results: 15.1% of patients had recorded SI, which was more common in dementia with Lewy bodies compared to other dementia diagnoses studied. After adjusting for sociodemographic and clinical factors, SI was more frequent in those with depression and dementia with Lewy bodies and less common in those with impaired activities of daily living and in vascular dementia. Agitated behavior and hallucinations were not associated with SI in the final model. Conclusions: Our findings highlight the importance of identifying and treating depressive symptoms in people with dementia and the need for further research into under-researched dementia subtypes.

KW - Alzheimer's dementia

KW - dementia

KW - dementia with Lewy bodies

KW - epidemiology

KW - suicidal ideation

KW - suicide

KW - vascular dementia

UR - https://www.scopus.com/pages/publications/85127586334

U2 - 10.1017/S1041610222000126

DO - 10.1017/S1041610222000126

M3 - Article

C2 - 35331357

AN - SCOPUS:85127586334

SN - 1041-6102

VL - 34

SP - 399

EP - 406

JO - International Psychogeriatrics

JF - International Psychogeriatrics

IS - 4

ER -