Researchers looked at the health records of nearly 600,000 people and found that those with dementia had a raised risk of suicide in the three months following diagnosis
“What it tells us is that period immediately after diagnosis is when people really need support from the services that provide the diagnosis.” Dr Charles Marshall, clinical senior lecturer and honorary consultant neurologist at Queen Mary University of London
People with a recent diagnosis of dementia, or who are diagnosed with the condition at a younger age, are at increased risk of suicide, research has found.
The researchers, who published their findings in JAMA Neurology, analysed data from people over the age of 15 in England during the period from 1 January 2001 to 31 December 2019.
They identified 14,515 people who died by suicide and had health records available. They then matched each individual with up to 40 living people from the same primary care practice but who may have had a different sex, set of health conditions, or background.
The team found that of the entire cohort of 594,674 individuals, 4,940 had a diagnosis of dementia, of whom 95 (about 2%) died by suicide. This rate was similar for those without dementia.
After taking into account factors such as age and sex, however, those who were diagnosed with dementia before the age of 65 were at 2.82 times increased risk of suicide compared with those without the condition. Researchers also found an increased risk of suicide in people in the first three months after diagnosis, and in those who had a psychiatric condition.
In the first three months after being told they had dementia, those diagnosed before the age of 65 had an almost seven times greater risk of suicide compared with those without dementia, although this reduced over time. Dr Charles Marshall, co-author of the study and a clinical senior lecturer and honorary consultant neurologist at Queen Mary University of London, said: “What it tells us is that period immediately after diagnosis is when people really need support from the services that provide the diagnosis.”
Marshall added that it was unclear whether the increased risk was a result of dementia causing people to feel suicidal, or other factors, such as people with a diagnosis feeling concerned they may become a burden to their family. He said: “What I tell people when they’re diagnosed is that it’s possible to find ways of maintaining quality of life that is acceptable to you after a diagnosis of dementia.”
Gavin Terry, head of policy at the Alzheimer’s Society, called for everyone diagnosed with dementia to have access to a dementia adviser or similar who could connect them with local support services: “No one should have to face dementia alone. Sadly, three in five people told us they haven’t received enough support from local services after their diagnosis, and just 0.2% of 1m referrals to talking therapy services mentioned a dementia diagnosis in 2018 – so we know people aren’t getting sufficient or timely mental health support.”
Dr Susan Mitchell, head of policy at Alzheimer’s Research UK, said that existing services tended to cater to people aged 65 years and over, which means it can be difficult for young people and their families to access appropriate support: “This, when combined with the fact that there are no treatments available in the UK that can slow or stop the progression of the underlying diseases that cause dementia, can be devastating to bear.” She added: ““Findings like this underpin the need for vital progress in developing new treatments, something that all of us working in dementia research are desperate to see.”
This is a striking finding from a large-scale piece of research. The mental health impact of different diseases and conditions certainly is an area where more research is needed. Neuropsychiatric illnesses take a toll on the mental health of patients and those supporting them. Although the findings of increased suicide risk in the immediate months following a dementia diagnosis, and in younger dementia patients, are troubling, they are very valuable in identifying where more support is needed. More joined-up services and enabling patient flow through straightforward pathways are critical here. We hope that policymakers and service providers are able to respond accordingly to improve services to help people cope with a diagnosis of dementia.