Apr 06, 2021

New study: Risk of suicide increases drastically after dementia diagnosis

Depressed older man

Researchers have found that rates of suicide increase sharply soon after a diagnosis of mild cognitive impairment, which can be a precursor to dementia.

Rates of suicide are also higher in those newly diagnosed with dementia.

The risk of suicide attempt was 73% higher in patients with a recent diagnosis of mild cognitive impairment, and 44% higher in patients with a recent diagnosis of dementia.

The findings have been reported in the journal JAMA Psychiatry.

The study looked at suicide attempts among nearly 148,000 older US Department of Veterans Affairs patients, and was the first time a link between suicide and the diagnosis of MCI has been studied.

What is MCI?

According to Dementia Australia, MCI (mild cognitive impairment) is memory loss that is greater than the usual level associated with ageing. Other signs of dementia, such as impaired reasoning or judgement, are not present with MCI.

MCI can be a precursor to dementia, but not always. It is estimated that people with MCI have a three to five times greater risk of developing dementia than others their age.

MCI has only recently been defined, and as such there is relatively little research on the topic, however, it is a growing field of study.

The study

The researchers looked at five Veterans Affairs databases, which amounted to nearly 148,000 people, with an average age of 75 years. Data was collected between 2011 and 2013.

The cohort was primarily male (97%) and white (86%).

More than 63,000 people in the group had already been diagnosed with dementia and about 21,000 had been diagnosed with MCI. 

There were 63,000 who had not been diagnosed with either MCI or dementia and they were used as a comparison group.

Data on suicide attempts was obtained from the National Suicide Prevention Applications Network and the Mortality Data Repository.

A ‘recent’ diagnosis was defined as anyone who has been diagnosed with dementia or MCI after 2011.

A total of 138 patients with MCI (0.7%) and 400 patients with dementia (0.6%) attempted suicide during the study, compared with 253 patients without MCI or dementia (0.4%). 

Why the sharp increase?

The authors of the study proposed several reasons people may be more likely to attempt to take their own lives soon after diagnosis of MCI or dementia.

People in the early stage of mental decline have “preserved insight” into what dementia entails. They may be “anticipating progressive cognitive and functional decline, fearing loss of autonomy, and worrying that they become a burden to significant others,” the researchers wrote. 

Those with MCI may also have higher rates of suicide because those around them may not have limited their access to things such as medication or weapons. In the household of a person who is known to be living with dementia, these steps may have already been taken.

MCI does not always lead to dementia

“Mild cognitive impairment may or may not progress to dementia,” the study authors noted. 

Some people with MCI “remain stable or even revert to a status of normal cognition”, they said.

People who have been diagnosed with MCI need not fear that developing dementia is an inevitability.

Diagnosis of MCI “profound, life-changing”

Being diagnosed with MCI or dementia is a “profound life-changing event” for which there is no treatment, the researchers said. 

Those who have been diagnosed should receive support and education to help them to “come to terms” with their situation, they recommend. 

Psychological distress, depression and anxiety should be given special attention among older people who have been diagnosed with MCI or dementia, and further study on the topic is required, the researchers noted.

A clear message for loved ones

The research holds a clear message for patients and their loved ones, Jami Halpern, a Neuropsychologist at Northwell Health’s Institute for Neurology and Neurosurgery in Great Neck, NY, told Health Day.

“Feelings of hopelessness or worthlessness and/or expression of feeling as though one is a burden are also potential indicators to be aware of,” she said. 

“Other signs may include a sudden improvement in mood without any apparent cause and/or giving personal items away, as these can be indicative of intent to carry out a plan to die by suicide.”

Talking to patients about thoughts of suicide was also vital, Halpern said.

“Often, loved ones or providers do not want to ask such questions due to fear it will trigger suicidal thoughts if they did not already exist,” she said. 

“However, this is not the case and often patients will divulge these types of thoughts to family or providers when asked and accept help.”

Helpern also said it was important for caregivers or family to remove access to potential means of dying by suicide, such as medication or weapons.

The research also makes clear the importance of connecting patients with support services as soon as a diagnosis has been given, with the aim of mitigating any feelings of depression, and addressing thoughts of suicide that may arise.

If this article has raised concerns for you, or if you are worried about someone you know, you can call Lifeline on 13 11 14.

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