Socio‐psychological factors in suicide with Alzheimer’s disease: comparative case studies of two patients in the USA and Japan

Abstract

The objective of this case report is to illustrate the influence of sociopsychological background on behavior in patients with Alzheimer's disease (AD). A comparative analysis was undertaken of two suicide cases with AD in the USA and Japan. Both cases were in the early stages of AD. They succeeded in suicide even with their disturbed executive functions, because they felt deprived of their dignity for different reasons according to their socio-cultural background. Early stage AD patients may retain the behavior and intellectual functions associated with their dignity and desire. Since dignity and desire are very cultural concerns, socio-psychological background should be cautiously considered when dealing with the emotional problems of AD patients.

Suicide capability within the ideation-to-action framework: A systematic scoping review

“…Four studies found suicide attempters had significantly impaired cognitive functioning when compared to suicide ideators [ 134 , 135 ] and controls [ 136 , 137 ]. Three association studies found cognitive deficits were reported by suicide attempters [ 138 ], including attempters with dementia [ 139 ], and identified in individuals who had an Alzheimer’s diagnosis and died by suicide [ 140 ].…”

Dementia and suicidal behavior: a review of the literature

“…Several case reports illustrate how patients with mild AD and preserved insight may be at risk (Margo and Finkel, 1990; Rohde et al ., 1995; Vega et al ., 2002; Lim et al ., 2005; Kishikawa et al ., 2007). However, a study of 118 people aged over 81 years found associations between both depression and AD/VaD, but no association between suicidal ideation and awareness of cognitive impairment or dementia severity (Rao et al ., 1997).…”

“…Suicide in dementia may occur in response to minor life events which highlight the individual's inability to deal with day-to-day problems (Hierholzer, 2002). Loss of dignity (Kishikawa et al ., 2007) and high premorbid social status (Margo and Finkel, 1990; Alexopoulos, 1991; Rohde et al ., 1995; Ferris et al ., 1999; Lim et al ., 2005) may also be risk factors, but these variables have a very limited evidence base.…”

Alzheimer's disease and mortality in Japan

“…The US Food and Drug Administration (FDA) warned in April 2005 that the death rate of elderly patients with dementia who were treated with atypical antipsychotic agents was approximately 1.6–1.7‐fold that of patients treated with placebo. Although the causes of death varied, 1,2 most seemed to be either heart related (e.g. heart failure or sudden death) or infections (pneumonia) 1 …”