Thursday, March 25, 2021

Recent Diagnosis of Cognitive Impairment, Dementia May Increase Suicide Risk

People diagnosed recently with mild cognitive impairment or dementia may be more likely to attempt suicide compared with those who have not received either diagnosis, according to a study published Wednesday in JAMA Psychiatry.

The findings point to the importance of offering supportive services to people at the time of or shortly after a diagnosis of mild cognitive impairment or dementia, wrote Mia Maria G√ľnak, M.Sc., of Leiden University in the Netherlands, Kristine Yaffe, M.D., of the University of California, San Francisco, and colleagues.

The researchers conducted a longitudinal cohort study, with a baseline period from October 1, 2011 to September 30, 2013, and follow-up through the end of 2016. They used five national databases, including the VA’s National Patient Care Database, which contained inpatient and outpatient records; the Centers for Medicare & Medicaid Services data, which contained medical claims and diagnoses; the National Suicide Prevention Applications Network; the Mortality Data Repository; and the VA’s Pharmacy Managerial Cost Accounting National Data Extract.

Patients aged 50 years or older were split between those who had a mild cognitive impairment or dementia diagnoses during or before the baseline period and a comparison group of participants who had received neither diagnosis. Diagnoses were considered recent if patients received them during the baseline period.

The total study population of 147,595 (mean age: 75 years) included 21,085 patients with mild cognitive impairment and 63,255 with dementia. Of the patients with mild cognitive impairment, 0.7% attempted suicide during the follow-up period, compared with 0.6% of patients with dementia and 0.4% of patients with neither diagnosis. Altogether, the risk of suicide attempt was 73% higher in patients recently diagnosed with mild cognitive impairment and 44% higher in those recently diagnosed with dementia, compared with those who had received neither diagnosis. Psychiatric comorbidity did not appear to change the associations between mild cognitive impairment or dementia and the risk of suicide attempt, the authors reported.

Additional analysis revealed that patients with a prior diagnosis of mild cognitive impairment or dementia (that is, those diagnosed before the baseline period) were no more likely to attempt suicide than others without these diagnoses.

“The findings in this cohort study suggest that patients who have recently been diagnosed with [mild cognitive impairment] or dementia should be viewed as a high-risk group for suicide attempt,” the authors concluded. “Additional supportive services in the care of patients with [mild cognitive impairment] or dementia are imperative, especially around the time of initial diagnosis.”

For related information, see the Psychiatric News article “Disclosure of Alzheimer’s Risk May Not Result in Short-Term Increase in Depression, Anxiety.”

(Image: iStock/PIKSEL)

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