- Design
- Systematic review and meta-analysis of observational studies
- Population
- 37 studies of people with dementia vs controls
- Primary outcome
- Suicide attempts and suicide deaths
- Effect
- Pooled OR 1.62 (95% CI 1.32–1.98) for suicidal behaviour
This systematic review and meta-analysis, published in May, pooled 37 observational studies of suicide attempts and deaths in people with dementia.
Dementia was associated with higher odds of suicidal behaviour than in people without dementia (pooled OR 1.62, 95% CI 1.32 to 1.98). Risk concentrated in younger patients, who were nearly three times as likely to die by suicide as older patients with dementia, and in men, whose odds of suicide death were almost three times those of women. Social isolation and a psychiatric history, particularly depression, were consistent risk markers. No eligible Chinese-language studies were found, and data from Asia were sparse.
The practical point is that the period around diagnosis, especially in younger-onset dementia, warrants direct questions about mood and suicidal thoughts. Indian data are lacking.
- Ask about mood and suicidal thoughts at and after a dementia diagnosis, especially in younger patients.
- Treat depression actively in people with dementia.
- Pay particular attention to men and to people living alone or socially isolated.
- Review access to means, including stored medications, when risk is identified.
- Involve family carers in safety planning where the patient agrees.
Why it matters
Suicide risk in dementia is easy to overlook because attention goes to cognition and safety at home.
Don't overread it
The studies were observational; risk factors here are markers, not proven causes.
The statistics, in plain English
An odds ratio of 1.62 means the odds of suicidal behaviour were about 60% higher with dementia. Because the studies were observational and varied, some of this may reflect depression or other factors rather than dementia itself.
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