Depression and Suicidal Ideation in Elders with Dementia

Kim, Jong Pil; Hyun, Mi Yeul

doi:10.4040/jkan.2013.43.2.296

Cited by 13 publications

(11 citation statements)

References 16 publications

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“…Patients suffering from organic mental disorders who previously underwent inpatient treatment complete suicide 10 times more often than outpatients [ 12 ]. Among ICD-10 F0 diagnoses, dementia constitutes a moderate risk if not more [ 99 , 100 , 101 , 102 , 103 , 104 ], including pre-emptive suicide [ 105 , 106 ].…”

Section: Suicide and Mental Illnessmentioning

confidence: 99%

Epidemiology of Suicide and the Psychiatric Perspective

Bachmann

2018

IJERPH

990

646

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Suicide is a worldwide phenomenon. This review is based on a literature search of the World Health Organization (WHO) databases and PubMed. According to the WHO, in 2015, about 800,000 suicides were documented worldwide, and globally 78% of all completed suicides occur in low- and middle-income countries. Overall, suicides account for 1.4% of premature deaths worldwide. Differences arise between regions and countries with respect to the age, gender, and socioeconomic status of the individual and the respective country, method of suicide, and access to health care. During the second and third decades of life, suicide is the second leading cause of death. Completed suicides are three times more common in males than females; for suicide attempts, an inverse ratio can be found. Suicide attempts are up to 30 times more common compared to suicides; they are however important predictors of repeated attempts as well as completed suicides. Overall, suicide rates vary among the sexes and across lifetimes, whereas methods differ according to countries. The most commonly used methods are hanging, self-poisoning with pesticides, and use of firearms. The majority of suicides worldwide are related to psychiatric diseases. Among those, depression, substance use, and psychosis constitute the most relevant risk factors, but also anxiety, personality-, eating- and trauma-related disorders as well as organic mental disorders significantly add to unnatural causes of death compared to the general population. Overall, the matter at hand is relatively complex and a significant amount of underreporting is likely to be present. Nevertheless, suicides can, at least partially, be prevented by restricting access to means of suicide, by training primary care physicians and health workers to identify people at risk as well as to assess and manage respective crises, provide adequate follow-up care and address the way this is reported by the media. Suicidality represents a major societal and health care problem; it thus should be given a high priority in many realms.

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Section: Suicide and Mental Illnessmentioning

confidence: 99%

Epidemiology of Suicide and the Psychiatric Perspective

Bachmann

2018

IJERPH

990

646

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“…Compared to data on suicide risk in people without dementia, data in people with dementia are scarce and based primarily on case reports [20][21][22] or studies of risk factors for suicide among people with dementia. 10,19,[23][24][25][26][27] Two studies have examined suicide risk in patients with dementia compared to those without dementia. 28,29 However, these studies included patients diagnosed with dementia during full-time admission to somatic or psychiatric hospitals 28 or patients with dementia who died by suicide and who were in contact with mental health services.…”

Section: Introductionmentioning

confidence: 99%

Suicide risk within 1 year of dementia diagnosis in older adults: a nationwide retrospective cohort study

Choi

Lee

Han

2021

jpn

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Background: Although severe dementia could protect against suicide death by decreasing a person’s capacity to implement a suicide plan, patients with early dementia may have better cognition, giving them more sustained insight into their disease and better enabling them to carry out a suicide plan. This study investigated suicide risk in older adults within 1 year of receiving a diagnosis of dementia. Methods: This study used National Health Insurance Service Senior Cohort data and included 36 541 older adults with newly diagnosed dementia (a Mini-Mental State Examination score ≤ 26 and a Clinical Dementia Rating score ≥ 1 or a Global Deterioration Scale score ≥ 3), including Alzheimer disease, vascular dementia and other/unspecified dementia, from 2004 to 2012. We selected older adults without dementia through 1:1 propensity-score matching using sex, age, comorbidities and index year, with follow-up throughout 2013. We estimated adjusted hazard ratios (AHRs) of suicide deaths within 1 year after diagnosis using a time-dependent Cox proportional hazards model. Results: We verified 46 suicide deaths during the first year after a dementia diagnosis. Older adults with dementia had an increased risk of suicide death compared to those without dementia (AHR 2.57; 95% confidence interval [CI] 1.49–4.44). Older adults with Alzheimer disease (AHR 2.50; 95% CI 1.41–4.44) or other/unspecified dementia (AHR 4.32; 95% CI 2.04–9.15) had an increased risk of suicide death compared to those without dementia. Patients with dementia but without other mental disorders (AHR 1.96; 95% CI 1.02–3.77) and patients with dementia and other mental disorders (AHR 3.22; 95% CI 1.78–5.83) had an increased risk of suicide death compared to patients without dementia. Patients with dementia and schizophrenia (AHR 8.73; 95% CI 2.57–29.71), mood disorders (AHR 2.84; 95% CI 1.23–6.53) or anxiety or somatoform disorders (AHR 3.53; 95% CI 1.73–7.21), respectively, had an increased risk of suicide death compared to patients with those conditions but without dementia. Limitations: This study examined only elderly patients in South Korea, a population with a substantially higher suicide rate than the global population. Caution must be exercised when generalizing the results to populations with dissimilar backgrounds. Conclusion: Patients with dementia had an increased risk of suicide death within 1 year after diagnosis compared to those without dementia.

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“…The Korea Centers for Disease Control and Prevention (2009) reported that depression was 2.5-7% more prevalent in female than male older adults. In contrast, some studies found no correlation between gender and depression Kim and Hyun, 2013).…”

Section: Discussionmentioning

confidence: 89%

“…This result was consistent with previous studies (Ravaglia et al ., 2008;Stepaniuk et al ., 2008). Approximately 83% of mild dementia patients assessed in a study, whose MMSE scores were 15 to 23, had depression and a higher prevalence of suicidal ideation (Kim and Hyun, 2013). On the other hand, another study found no difference in the degree of depression between older adults with mild cognitive impairment and those having normal cognitive function (Shin et al ., 2012).…”

Section: Discussionmentioning

confidence: 96%

Depression and suicidal ideation in community-dwelling older adults in Korea

Kwon¹,

손명지²

2014

Journal of the Korean Data and Information Science Society

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This study aimed to investigate the prevalence of depression and suicidal ideation in community-dwelling older adults in Korea, as well as identify factors associated with their occurrence, including cognitive impairment. A cross-sectional study of 484 residents was conducted at a senior centre utilising the PHQ-9K and K-MMSE. Demographic data were also collected for analysis. Of the respondents, 38.1% had symptoms of mild to severe depression. Further, 16.7% reported having suicidal ideation, with 5% of respondents having thoughts of suicide every day. The majority of participants had 'normal' scores on the K-MMSE (88.0%), though significant differences were observed in PHQ-9K scores between cognitive-acceptable and cognitive-impaired groups. Depressive symptoms and suicidal ideation were very prevalent in community-dwelling older adults in Korea. This study indicates the need for the development of communitybased mental health programs tailored to older adults, and demonstrates the viability of promoting early detection of depressive symptoms through senior centres.

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Depression and Suicidal Ideation in Elders with Dementia

Abstract: The results of this study can be utilized in the development of suicide prevention programs for older adults with dementia. In particular, depression should be screened and managed to reduce suicidal ideation of older adults with dementia.

Cited by 13 publications

References 16 publications

Epidemiology of Suicide and the Psychiatric Perspective

Epidemiology of Suicide and the Psychiatric Perspective

Suicide risk within 1 year of dementia diagnosis in older adults: a nationwide retrospective cohort study

Depression and suicidal ideation in community-dwelling older adults in Korea

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