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TOPLINE:

Dementia was associated with a higher risk for suicidal behavior, especially in younger vs older individuals and in men vs women, a new meta-analysis showed.

METHODOLOGY:

• A systematic review and meta-analysis included 37 observational studies examining suicidal behavior in individuals with a diagnosis of dementia or probable dementia, including 14 cohort studies, 20 case-control studies, and three cross-sectional studies.
• Researchers compared individuals with dementia and those without dementia to assess the overall risk for suicidal behavior. Specific risk factors were also assessed, including age, sex, psychiatric history, and the use of psychotropic medications.
• Outcomes included suicide attempts and deaths by suicide.

TAKEAWAY:

• In pooled analyses, dementia was associated with an increased risk for suicidal behavior compared with no dementia (odds ratio [OR], 1.66; P < .01) and with significantly elevated risk for both suicide attempt (OR, 1.98) and death by suicide (OR, 1.50).
• Younger vs older age was a significant risk factor for suicidal behavior in patients with dementia (OR, 2.34; P < .001), and men had a higher risk than women (OR, 1.69; P = .01).
• Psychiatric history was significantly linked to an increased risk for suicidal behavior (OR, 2.04; P < .001), especially depression (OR, 4.30), anxiety (OR, 1.76), and substance use (OR, 1.68); bipolar disorder and schizophrenia showed no significant associations. Huntington disease was also associated with an elevated suicidal behavior risk (OR, 8.70; P < .01).
• Psychotropic use was linked to an increased risk for death by suicide in patients with dementia (OR, 2.44; P < .001), with a significant risk for hypnotics (OR, 3.09), anxiolytics (OR, 3.06), and antidepressants (OR, 2.49) but not antipsychotics.

IN PRACTICE:

The review showed that suicidal behavior risk in patients with dementia “is a concentrated rather than universal phenomenon,” the investigators wrote.

“By addressing existing research gaps and prioritizing the identified high-risk markers, future psychiatric practice can transition from reactive management to a more proactive, evidence-based preventive framework,” they added. 

SOURCE:

This study was led by Yin-Ting Chen, PhD, University of Birmingham, Birmingham, England. It was published online on May 29 in the Journal of Affective Disorders. 

LIMITATIONS:

The key findings in the included studies were disproportionately weighted toward suicide deaths rather than suicide attempts, which limited the complete understanding of suicidal behavior. Additionally, the substantial statistical heterogeneity observed across studies (I² values exceeding 95% in many analyses) suggested variability in study populations, methodologies, and outcome definitions.

DISCLOSURES:

This study did not receive any funding, and the investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.