Objective
The current study aims to examine the risk of suicide in persons diagnosed with dementia
during a hospitalization and its relationship to mood disorders.
Design
Event-history analysis using time-varying covariates.
Setting
Population-based record linkage.
Participants
All individuals aged 50+ living in Denmark (N = 2,474,767) during January 1, 1990
through December 31, 2000.
Measurements
Outcome of interest is suicide. Relative risks are calculated based on person-days
spent in each stratum.
Results
A total of 18,648,875 person-years were observed during the 11-year study period.
During this period, 136 persons who previously had been diagnosed with dementia died
by suicide. Men and women aged 50–69 years with hospital presentations of dementia
have a relative suicide risk of 8.5 (95% confidence interval: 6.3–11.3) and 10.8 (95%
confidence interval: 7.4–15.7), respectively. Those who are aged 70 or older with
dementia have a threefold higher risk than persons with no dementia. The time shortly
after diagnosis is associated with an elevated suicide risk. The risk among persons
with dementia remains significant when controlling for mood disorders. As many as
26% of the men and 14% of the women who died by suicide died within the first 3 months
after being diagnosed whereas 38% of the men and 41% of the women died more than 3
years after initial dementia diagnosis.
Conclusions
Dementia, determined during hospitalization, was associated with an elevated risk
of suicide for older adults. Preventive measures should focus on suicidal ideation
after initial diagnosis but also acknowledge that suicides can occur well after a
dementia diagnosis has been established.
Key Words
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Article info
Publication history
Accepted:
September 14,
2007
Received in revised form:
September 12,
2007
Received:
January 28,
2007
Footnotes
The authors thank four anonymous reviewers for helpful comments.
The authors gratefully acknowledge funding from the American Foundation for Suicide Prevention and the Danish Velux Foundation (to AE) and the NIMH (P20 MH071897) (to YC). Research at the National Centre for Register-based Research is in part funded through a collaborative agreement with Centre for Basic Psychiatric Research, Aarhus, Denmark.
Identification
Copyright
© 2008 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
