A recent diagnosis of dementia is associated with short-term higher suicide risk, according to a study presented in a poster at the virtual 2021 annual meeting of the American Association for Geriatric Psychiatry.
Clinicians should implement suicide risk screening, assess caregiver and patient needs, initiate referrals for support services, and offer lethal means restriction at the time of diagnosing incident dementia, researchers said.
“After being diagnosed with dementia, many older adults feel loss, anger, and uncertainty,” they wrote.
Researchers from Yale University, New Haven, Connecticut, University of Michigan, Ann Arbor, Columbia University, New York, New York, and the University of Pennsylvania, Philadelphia, identified a national cohort of more than 2.5 million Medicare fee-for-service beneficiaries aged 65 years or older with newly diagnosed dementia linked to the National Death Index between 2012 and 2015.
Using stratified standardized mortality ratios (SMRs), researchers quantified the risk of suicide compared to the general older adult population using the Centers for Disease Control and Prevention’s Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER).
“The suicide rate for the dementia cohort was 26.42 per 100,000 person-years. The overall SMR for suicide was 1.53 with the highest risk among adults aged 65-74 years and during the first 90 days following dementia diagnosis,” researchers said.
Approximately half of all suicide deaths occurred within 90 days of diagnosis. Firearms were the most common method, used in 63.3% of the suicide-related deaths, the study found. Clinicians should implement means restriction and safety counseling with patients and caregivers, such as safe storage or the removal of firearms, the researchers recommended based on the findings.
Factors that increased the risk of suicide among those studied were living in a rural residence, having any recent diagnosed mental or substance use disorder, recent chronic pain conditions, and frontotemporal dementia, the study found. Researchers suggest that clinicians refer patients to services and specialist care for mental health, pain, social services, and any other necessary supports.
Low income subsidy was found to decrease the risk of suicide and the severity of medical comorbidity was not associated with increased risk.
Schmutte T, Donovan M, Olfson M, et al. Suicide risk in the first year following dementia diagnosis: a national study of US older adults. Poster presented at the American Association for Geriatric Psychiatry 2021 Annual Meeting; March 15-19, 2021; Virtual.