Suicide risk in caregivers of people with dementia: a systematic review and meta-analysis

Abstract

Background Interest in physical and mental health outcomes in caregivers of patients with dementia is increasing. However, there is limited data available on the prevalence of suicidal ideation, suicidal attempts, and suicide rates among caregivers of those with dementia. Therefore, we aimed to systematically review these outcomes to address this gap in the literature and thus provide information to inform future policy and intervention for the benefit of caregivers of dementia patients. Methods We searched several databases from inception to the 10th November 2021, for studies investigating suicidal ideation, suicidal attempts, and suicide rates of caregivers of patients with dementia. We report data regarding suicidal ideation as prevalence, with the 95% confidence intervals (CIs), applying a random-effect model; since less than three studies were available for suicide attempt and suicide, these data are reported descriptively. Results Among 194 articles, eight comprising 1,209 informal caregivers of people with dementia (mean age: 63.9 years, 74% females) were included. The prevalence of suicide ideation was 32.32% (95% CI: 16.01–48.64%; I2 = 98.5%, p < 0.0001). The prevalence of suicide ideation varied between studies from 4.69% to 77.78%. Two studies reported the rate of suicidal attempt in caregivers of patients with dementia, with the prevalence ranging from 5.9% to 16.1%. One study reported one in 17 caregivers of patients with dementia died by suicide. Conclusions The prevalence of suicide ideation is high, affecting several caregivers of patients with dementia. These findings suggest intervention and/or policy are urgently needed to address suicidal behavior in this at-risk population.

2023 Alzheimer's disease facts and figures

“…Caring for people with dementia who have four or more behavioral and psychological symptoms (for example, aggression, self‐harm and wandering) represents a “tipping point,” as these caregivers are more likely to report clinically meaningful depression and burden 487 A systematic review found the prevalence of suicide ideation (thinking about or making plans for suicide) in dementia caregivers with a mean age of 64 was 32% compared with 2.7% in U.S. adults age 56 and older 488,489 Sexual gender minority dementia caregivers are significantly younger and more likely to be employed than heterosexual dementia caregivers and indicate greater difficulty when paying for necessities while also reporting higher family quality of life than their heterosexual peers 490 …”

“…487 • A systematic review found the prevalence of suicide ideation (thinking about or making plans for suicide) in dementia caregivers with a mean age of 64 was 32% compared with 2.7% in U.S. adults age 56 and older. 488,489 • Sexual gender minority dementia caregivers are significantly younger and more likely to be employed than heterosexual dementia caregivers and indicate greater difficulty when paying for necessities while also reporting higher family quality of life than their heterosexual peers. 490 • Providing physical and medical care is associated with worse mental health among dementia caregivers than non-dementia caregivers.…”

2024 Alzheimer's disease facts and figures

“…532 • A systematic review found the prevalence of suicidal ideation (thinking about or making plans for suicide) in dementia caregivers with a mean age of 64 was 32% compared with 2.7% in U.S. adults age 56 and older (please note that an exact age comparator is not available). 533,534 • Providing physical and medical care is associated with worse mental health among dementia caregivers than non-dementia caregivers. 490 Other Key Findings About the Challenges of Dementia Caregiving…”

Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions

“…[6][7][8][9] Meta-analyses have consistently reported that the prevalence of depressive and anxiety symptoms in this cohort is as high as 21% to 57%, [10][11][12] leading to decreased care quality, 13 greater economic impacts, 4,14 poor quality of life for both caregivers and care recipients, 15,16 and even caregivers' suicide. 17,18 Moreover, the overwhelming and unavoidable caregiving burden can diminish caregivers' self-awareness of their own needs and hinder help-seeking. [19][20][21] Proactive support to promote the psychological wellness of caregivers is urgently needed to sustain the informal care resource.…”

“…Unprepared informal caregivers must cope with various competing roles and multiple stressors when taking care of patients throughout the deteriorating and debilitating chronic disease trajectory, leading to a higher psychological burden than formal caregivers and noncaregivers . Meta-analyses have consistently reported that the prevalence of depressive and anxiety symptoms in this cohort is as high as 21% to 57%, leading to decreased care quality, greater economic impacts, poor quality of life for both caregivers and care recipients, and even caregivers’ suicide . Moreover, the overwhelming and unavoidable caregiving burden can diminish caregivers’ self-awareness of their own needs and hinder help-seeking .…”