People with dementia may be at higher risk of having suicidal thoughts

People with dementia are more likely to have suicidal thoughts, but are not necessarily more likely to commit suicide or die than the general population, according to a new study led by UCL researchers.

The study, published in Aging research reviewsanalyzed 54 studies that examined various aspects of mental health – including the prevalence and risk of suicide – in people with dementia between 1991 and 2023.

Dementia is an escalating global health problem, affecting an estimated 55 million people worldwide. In addition to affecting cognitive abilities, people with dementia often experience debilitating neurological and psychological symptoms such as depression, apathy, aggression and anxiety.

These symptoms can sometimes lead to increased emotional distress and, in some cases, suicidal thoughts.

The researchers combined data from twenty studies of suicidal thoughts in people with dementia, involving more than 1.5 million people. They found that 10% of people with dementia had suicidal thoughts, compared to the World Health Organization’s estimate of 2% for the general population.

People with moderate dementia were more likely to have suicidal thoughts than people with mild dementia.

However, after reviewing data from more than 3.7 million people with dementia, researchers found that the prevalence of suicide attempts or attempted suicide was about the same as the prevalence in the general population: 0.8% of people with dementia attempted suicide within a period of two years.

The team found that 0.1% of people with dementia died by suicide, and that younger people with dementia were about three times more likely to be affected than people who were older.

Even though men were less likely to report suicidal thoughts, they were significantly more likely to commit suicide and almost three times as likely to die by suicide than women.

Dementia is a growing global health problem as more and more people live long enough to develop it.

People with dementia may be at greater risk of suicidal thoughts and certain groups in particular, such as men and younger people with dementia, may be at greater risk of dying by suicide, but this field has not been well studied. The current NICE guidelines for the Assessment, Management and Support of People with Dementia do not mention suicidality in this population, nor discuss how this risk can be assessed or managed. This means that physicians do not routinely assess or actively manage this risk.

This review highlights the importance of providing mental health care and suicide prevention in dementia care, with a focus on age, symptom severity and gender.”

Dr. Roopal Desai, Lead author, UCL Psychology and Linguistics

In light of the study’s findings, the researchers are now calling on doctors and caregivers to be vigilant when assessing the emotional well-being of people with dementia, to ensure timely support and patient safety.

Senior author Dr Amber John said: “It is often assumed that suicide is not a problem in people with dementia. This study shows that people with dementia are no less likely to attempt suicide or die by suicide than the general population – and that is true. more likely to have suicidal thoughts.

“This means that suicide risk should be taken as seriously in people with dementia as in the general population.”

The research was supported by the Welsh National Health Service.

Professor Alberto Salmoiraghi, Medical Director of the Betsi Cadwaladr University Health Board (BCUHB), co-author of the paper, said: “These findings are truly important for clinicians and of paramount importance to inform future developments in service provision, especially with regarding risk assessments and care pathways.”

Study limitations

The study examined different ways in which people expressed suicidal thoughts and involved both clinical and community samples, which may influence incidence rates.

Also, the researchers were unable to analyze all risk factors for suicide due to a lack of information from existing studies.

Furthermore, the findings do not take into account different subtypes of dementia (i.e. frontotemporal dementia may confer a higher suicide risk due to behavioral changes and aggression).