Suicide and dementia: A systematic review and meta-analysis of prevalence and risk factors

Roopal Desai; Anastasia Tsipa; Caroline Fearn; Céline El Baou; Emilie V Brotherhood; Georgina Charlesworth; Sebastian J Crutch; Katie Flanagan; Amy Kerti; Suman Kurana; Radvile Medeisyte; Eleanor Nuzum; Tom G Osborn; Alberto Salmoiraghi; Joshua Stott; Amber John

doi:10.1016/j.arr.2024.102445

Suicide and dementia: A systematic review and meta-analysis of prevalence and risk factors

Ageing Res Rev. 2024 Sep:100:102445. doi: 10.1016/j.arr.2024.102445. Epub 2024 Aug 8.

Authors

Roopal Desai¹, Anastasia Tsipa², Caroline Fearn³, Céline El Baou⁴, Emilie V Brotherhood⁵, Georgina Charlesworth⁶, Sebastian J Crutch⁷, Katie Flanagan⁸, Amy Kerti⁹, Suman Kurana¹⁰, Radvile Medeisyte¹¹, Eleanor Nuzum¹², Tom G Osborn¹³, Alberto Salmoiraghi¹⁴, Joshua Stott¹⁵, Amber John¹⁶

Affiliations

¹ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].
² ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].
³ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].
⁴ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].
⁵ Dementia Research Centre, University College London, London, UK. Electronic address: [email protected].
⁶ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK; Research and Development, North East London NHS Foundation Trust, London, UK. Electronic address: [email protected].
⁷ Dementia Research Centre, University College London, London, UK. Electronic address: [email protected].
⁸ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK; Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK. Electronic address: [email protected].
⁹ Betsi Cadwaladr University Health Board, Cymru NHS, Wales, UK. Electronic address: [email protected].
¹⁰ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].
¹¹ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].
¹² ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].
¹³ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].
¹⁴ Betsi Cadwaladr University Health Board, Cymru NHS, Wales, UK. Electronic address: [email protected].
¹⁵ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].
¹⁶ ADAPT Lab, Clinical, Educational and Health Psychology Department, University College London, London, UK. Electronic address: [email protected].

PMID: 39127443
DOI: 10.1016/j.arr.2024.102445

Abstract

Dementia is a global health concern with increasing numbers of people living long enough to develop dementia. People with dementia (PwD) may be particularly vulnerable to suicidality. However, suicide in PwD has not been thoroughly explored. The objective of this review was to determine the prevalence and risk factors of suicide in PwD. Five databases were searched from inception to July 2023. Peer-reviewed publications reporting prevalence, risk factors or quantitative summary data for suicide outcomes in PwD were included. Random effects models were used to calculate the pooled prevalence and effect sizes. 54 studies met inclusion criteria. In PwD, the point prevalence of suicidal ideation was 10 % (95 %CI=6 %;16 %), 2-year period prevalence of suicide attempts was 0.8 % (95 %CI=0.3 %;2 %), 10-year period prevalence of suicide attempts was 8.7 % (95 %CI=6.0 %%;12.7 %) and the incidence of death by suicide 0.1 % (95 %CI=0.1 %;0.2 %). Compared to not having dementia, a diagnosis of dementia increased risk of suicidal ideation (OR=1.62[95 %CI=1.17;2.24]) but not risk of suicide attempt (OR=1.77 [95 %CI=0.85;3.69]) or death by suicide (OR=1.30 [95 %CI=0.81;2.10]). People with moderate dementia had significantly increased risk of suicidal ideation than those with mild dementia (OR=1.59[95 %CI=1.11;2.28]), younger PwD were at increased risk of dying by suicide (OR=2.82[95 %CI=2.16;3.68]) and men with dementia were more likely to attempt (OR=1.28[95 %CI=1.25;1.31]) and die by suicide (OR=2.88[95 %CI=1.54;5.39]) than women with dementia. This review emphasises the need for mental health support and suicide prevention in dementia care, emphasising tailored approaches based on age, symptoms, and being male.

Keywords: Dementia; Meta-analysis; Suicide.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Dementia* / epidemiology
Dementia* / psychology
Humans
Male
Prevalence
Risk Factors
Suicidal Ideation*
Suicide* / psychology
Suicide* / statistics & numerical data
Suicide, Attempted / psychology
Suicide, Attempted / statistics & numerical data