Anticipated suicidal and death ideation in response to an imagined dementia diagnosis: A qualitative study

Abstract

Alzheimer’s disease and related dementias are prevalent, highly impactful, and feared diagnoses. A mixed methods study using semi-structured interviews was conducted to clarify causes of dementia-related anxiety. Fifty community-dwelling adults aged 58 to 89 ( M = 70.92, SD = 6.08) were recruited from a university participant registry and Memory Clinic; none had dementia diagnoses. Analyses revealed that 42% ( n = 21) of participants anticipated suicidal or death ideation if diagnosed with dementia. Among participants endorsing anticipated suicidal or death ideation, responses ranged from active, specific plans, including interest in physician-assisted suicide, to more passive wishes to hasten death rather than continue to live with dementia. Within reports of both anticipated suicidal and death ideation, three subthemes emerged. Participants reported concerns about becoming a burden to others, the devaluation of life/loss of self with dementia, and the desire for (and anticipated thwarting of) personal control as factors contributing to their anticipated responses to a dementia diagnosis. Statements of anticipated suicidal and death ideation were contingent on a dementia diagnosis and may reflect errors in affective forecasting. Nevertheless, given the prevalence of dementias and older adults’ elevated rates of suicide, the intersection of these two public health issues warrants greater attention.

Dementia Disorders: A Narrative Review

“…In a paper entitled "Anticipated suicidal and death ideation in response to an imagined dementia diagnosis: a qualitative study", 50 adults 58-to-89-years-old who were attending a memory clinic for dementia were interviewed [9]. As many as 42 % of the sample anticipated that they would experience suicidality or death ideation if diagnosed with dementia.…”

Necropolitics of Death in Neurodegeneration

“…Foucault pointed out how biopower is often self-invocated and reinforced by individuals (Foucault, 1978 ). Necropower can also be self-invoked, as evidenced by the presence of suicidal and death ideation in newly diagnosed patients, with 42% of individuals exhibiting such thoughts, especially during the initial 90 days following diagnosis (Maxfield et al., 2023 ). Normalization of death is often reinforced by a medicalized approach to illness that tends to focus on curative treatments and the preservation of physical functioning.…”