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Risk of Suicide After Dementia Diagnosis

Alothman, Danah; Card, Timothy; Lewis, Sarah; Tyrrell, Edward; Fogarty, Andrew W.; Marshall, Charles R.

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Danah Alothman

Clinical Associate Professor

Clinical Associate Professor & Reader in Clinical Epidemiology

Charles R. Marshall


Importance: Patients with dementia may be at an increased suicide risk. Identifying groups at greatest risk of suicide would support targeted risk reduction efforts by clinical dementia services.

Objectives: To examine the association between a dementia diagnosis and suicide risk in the general population and to identify high-risk subgroups.

Design, Setting, and Participants: This was a population-based case-control study in England conducted from January 1, 2001, through December 31, 2019. Data were obtained from multiple linked electronic records from primary care, secondary care, and the Office for National Statistics. Included participants were all patients 15 years or older and registered in the Office for National Statistics in England with a death coded as suicide or open verdict from 2001 to 2019. Up to 40 live control participants per suicide case were randomly matched on primary care practice and suicide date.

Exposures: Patients with codes referring to a dementia diagnosis were identified in primary care and secondary care databases.

Main Outcomes and Measures: Odds ratios (ORs) were estimated using conditional logistic regression and adjusted for sex and age at suicide/index date.

Results: From the total sample of 594674 patients, 580159 (97.6%) were controls (median [IQR] age at death, 81.6[72.0-88.4] years; 289769 male patients [50.0%]), and 14515 (2.4%) died by suicide (median [IQR] age at death, 47.4 [36.0-59.7] years; 10850 male patients [74.8%]). Among those who died by suicide, 95 patients (1.9%) had a recorded dementia diagnosis (median [IQR] age at death, 79.5 [67.1-85.5] years; median [IQR] duration of follow-up, 2.3 [1.0-4.4] years). There was no overall significant association between a dementia diagnosis and suicide risk (adjusted OR, 1.05; 95% CI, 0.85-1.29). However, suicide risk was significantly increased in patients diagnosed with dementia before age 65 years (adjusted OR, 2.82; 95% CI, 1.84-4.33), in the first 3 months after diagnosis (adjusted OR, 2.47; 95% CI, 1.49-4.09), and in patients with dementia and psychiatric comorbidity (adjusted OR, 1.52; 95% CI, 1.21-1.93). In patients younger than 65 years and within 3 months of diagnosis, suicide risk was 6.69 times (95% CI, 1.49-30.12) higher than in patients without dementia.

Conclusions and Relevance: Diagnostic and management services for dementia, in both primary and secondary care settings, should target suicide risk assessment to the identified high-risk groups..


Alothman, D., Card, T., Lewis, S., Tyrrell, E., Fogarty, A. W., & Marshall, C. R. (2022). Risk of Suicide After Dementia Diagnosis. JAMA Neurology, 79(11), 1148-1154.

Journal Article Type Article
Acceptance Date Aug 1, 2022
Online Publication Date Oct 3, 2022
Publication Date Oct 3, 2022
Deposit Date Nov 8, 2022
Publicly Available Date May 9, 2023
Journal JAMA Neurology
Print ISSN 2168-6149
Electronic ISSN 2168-6157
Peer Reviewed Peer Reviewed
Volume 79
Issue 11
Pages 1148-1154
Keywords Neurology (clinical)
Public URL
Publisher URL


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