New research identifies link between dementia and self-harm

A groundbreaking Australian study has established a link between dementia and increased levels of self-harm within the first six to 12 months after diagnosis.

Researchers from UNSW Sydney analysed data from over 180,000 people admitted to hospital between 2001-15, split into two cohorts: 154,811 patients recorded as having dementia and 28,972 patients admitted for self-harm injuries.

Of the people recorded as having dementia, 692 were readmitted for self-harm. The majority of those instances occurred within the first 12 months following a hospital visit for dementia.

Lead author, Doctor Adrian Walker, said the study provided concrete evidence of a link between dementia and self-harm, and the findings have helped create a picture for the prevalence rate and any predictors.

“We know that that’s an important question because dementia itself is associated with not only a lot of neurological changes but also a lot of grief and a lot of anxiety,” Dr Walker explained. “It can create this perfect storm of factors that may contribute to self-harm.”

Stephen Grady, 68, was diagnosed with younger onset dementia eight years ago. At the time he still worked as a measurement scientist, but his dementia diagnosis delivered a heavy emotional toll.

“So here was me as a very high functioning member of society, one of the leading people in my field,” Mr Grady said.

“And then suddenly after being diagnosed, it felt like I went from a valuable contributor to society to having no value at all. So, there’s this whole question of, okay, ‘Is your life over, is it still worth living?’. These are the kinds of questions that I believe a lot of us ask ourselves, but it’s only when you find the value in your life again, that you can refute them.”

Men more likely to self-harm after diagnosis

Nearly two-thirds of Australians with dementia are women, and it is also now the leading cause of disease burden. The UNSW Sydney findings reflected its prominence among women, but it also found that:

• The majority of patients admitted for dementia were women (60%) 
• There was a relatively even split for self-harm admissions, with women the majority (53%)
• Men were more likely to self-harm following a dementia diagnosis (60%)
• People diagnosed at a younger age had more recorded instances of self-harm 
• There were higher rates of self-harm in patients with dementia who had a partner, as opposed to divorced, widowed or separated patients

Due to the prevalence of self-harm within the first 12 months of a dementia diagnosis, UNSW Scientia Associate Professor Simone Reppermund said health services and practitioners should place more significance on mental health support.

“The message to clinicians and indeed, the outside world, is that it is really important, once a person gets a diagnosis of dementia, that psychosocial and mental health supports are kicking in straight away,” Prof Reppermund said.

“We would like to see people who are initially diagnosed get the support very early on to prevent self-harm and suicide later on. Even without dementia, men 85 and over are in the age group with the highest age-specific suicide rates, so it’s doubly important we offer extra care for people diagnosed with dementia.”

Lifeline: 13 11 14 lifeline.org.au
Suicide Call Back Service: 1300 659 467 suicidecallbackservice.org.au
Beyond Blue: 1300 224 636 beyondblue.org.au/forums
MensLine Australia: 1300 789 978 mensline.org.au
National Dementia Helpline: 1800 100 500 dementia.org.au/helpline