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Suicidal ideation in dementia: associations with neuropsychiatric symptoms and subtype diagnosis

Naismith, Hamish; Howard, Robert; Stewart, Robert; Pitman, Alexandra; Mueller, Christoph; (2022) Suicidal ideation in dementia: associations with neuropsychiatric symptoms and subtype diagnosis. International Psychogeriatrics 10.1017/S1041610222000126. (In press). Green open access

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Abstract

OBJECTIVES: To investigate factors associated with suicidal ideation (SI) around the time of dementia diagnosis. We hypothesised relatively preserved cognition, co-occurring physical and psychiatric disorders, functional impairments, and dementia diagnosis subtype would be associated with a higher risk of SI. DESIGN: Cross-sectional study using routinely collected electronic mental healthcare records. SETTING: National Health Service secondary mental healthcare services in South London, UK, serving a population of over 1.36 million residents. PARTICIPANTS: Patients who received a diagnosis of dementia (Alzheimer's, vascular, mixed Alzheimer's/vascular, or dementia with Lewy bodies) between 1 Nov 2007-31 Oct 2021: 18,252 people were identified during the observation period. MEASUREMENTS: A natural language processing algorithm was used to identify recorded clinician recording of SI around the time of dementia diagnosis. Sociodemographic and clinical characteristics were also measured around the time of diagnosis. We compared people diagnosed with non-Alzheimer's dementia to those with Alzheimer's and used statistical models to adjust for putative confounders. RESULTS: 15.1% of patients had recorded SI, which was more common in dementia with Lewy bodies compared to other dementia diagnoses studied. After adjusting for sociodemographic and clinical factors, SI was more frequent in those with depression and dementia with Lewy bodies and less common in those with impaired activities of daily living and in vascular dementia. Agitated behavior and hallucinations were not associated with SI in the final model. CONCLUSIONS: Our findings highlight the importance of identifying and treating depressive symptoms in people with dementia and the need for further research into under-researched dementia subtypes.

Type: Article
Title: Suicidal ideation in dementia: associations with neuropsychiatric symptoms and subtype diagnosis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S1041610222000126
Publisher version: https://doi.org/10.1017/S1041610222000126
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Alzheimer’s dementia, dementia, dementia with Lewy bodies, epidemiology, suicidal ideation, suicide, vascular dementia
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10146504
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