Suicide risk in first year after dementia diagnosis in older adults

Schmutte, Timothy; Olfson, Mark; Maust, Donovan T.; Xie, Ming; Marcus, Steven C.

doi:10.1002/alz.12390

Cited by 43 publications

(48 citation statements)

References 52 publications

(53 reference statements)

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“…Regarding ADL and cognitive functioning, the suicide rate among older adults with dementia was higher when their ADL and cognitive functioning were mild rather than severe. This is consistent with recent studies showing that older adults diagnosed with dementia very recently are more likely to attempt suicide [4,14,[16][17][18][19][20][21]. In Korea, a study assessing the effects of "a suicide prevention program" for older adults with mild dementia showed positive effects on perceived health conditions, social support, depression, and suicidal intentions over time [25].…”

Section: Discussionsupporting

confidence: 89%

“…Among the older adults who committed suicide due to dementia, the overall suicide attempts and suicide rates were higher among patients with mild dementia who had been recently diagnosed [14,[16][17][18]. Similarly, suicide attempts among these patients were higher than among older adults with light cognitive impairment [19][20][21].…”

Section: Of 14mentioning

confidence: 94%

“…Several studies have verified the cause of suicide in older people with dementia at the individual level [12][13][14][15][16][17][18][19][20][21]. According to the interpersonal theory of suicidal behavior, the most dangerous aspect of suicidal desire is the coexistence of both a thwarted belongingness-feeling disconnected from a social relationship-and a perceived burdensomeness-perceiving oneself as a burden on others [14].…”

Section: Of 14mentioning

confidence: 99%

“…LTCS: Long-Term Care Service.2 Income level: first quintile (Medical aid beneficiaries), second quintile (The NHI premium for the tenth quantile: first-third), third quintile (fourth-fifth), fourth quintile (sixth-eighth), and fifth quintile (ninth-tenth) 3. Activity Daily Limitation: Independent (score[13][14][15][16][17][18][19], partially dependent (score 20-26), and fully dependent (score 27-39) 4. Cognitive ability: Good (score 0-5) and Bad (score 6-10).…”

mentioning

confidence: 99%

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Suicide among Older Adults with Dementia: Effects of Korea’s Long-Term Care Insurance System

Moon¹,

Choi

Sohn

2021

IJERPH

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South Korea recently expanded its coverage rate of long-term care insurance (LTCI) by adding a “dementia special grade” in 2014 to improve care service accessibility and extend health life for older adults with dementia. In this study, we propose a multifaceted policy to reduce the suicide risk among older adults with dementia by evaluating the effectiveness of using the long-term care services (LTCS). A sample of 62,282 older adults was selected from the “Older Adults Cohort DB” of the National Health Insurance Service. We conducted Kaplan–Meier and Cox regression to represent the yearly survival curve from 2002 to 2015 according to the individual characteristics. Difference-in-difference estimation was conducted to identify the effect of LTCS on suicide rates by using LTCS before and after 2014. The suicide risk of older adults using LTCS was about 0.256-times lower than those who did not use it (OR = 0.296, 95% CI = 0.183–0.478), whereas it increased after the expansion of the dementia grading (OR = 2.131, 95% CI = 1.061–4.280). To prevent the risk of suicide among older adults with dementia, not only did the mortality rate vary depending on the sex, activities of daily living (ADL), and type of caregiver at the individual level but appropriate national intervention and management, such as improving the accessibility of LTCS, are also needed.

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Section: Discussionsupporting

confidence: 89%

Section: Of 14mentioning

confidence: 94%

Section: Of 14mentioning

confidence: 99%

mentioning

confidence: 99%

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Suicide among Older Adults with Dementia: Effects of Korea’s Long-Term Care Insurance System

Moon¹,

Choi

Sohn

2021

IJERPH

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“…People living with Alzheimer's disease (AD) and AD-related dementias (ADRDs) are at a higher risk of suicidal behaviors given intersecting risk factors [7,8]. AD/ADRDs are associated with cognitive decline, personality changes, psychiatric illnesses, functional impairment, comorbid illnesses, dependence on formal and informal caregivers, and disease stigma [9,10].…”

Section: Introductionmentioning

confidence: 99%

Suicidal Ideation and Suicide-Attempt-Related Hospitalizations among People with Alzheimer’s Disease (AD) and AD-Related Dementias in the United States during 2016–2018

Alipour-Haris

Armstrong

Sullivan

et al. 2022

JCM

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People living with Alzheimer’s disease (AD) and AD-related dementias (ADRDs) are at a higher risk of suicidal behaviors given intersecting risk factors. Previous studies generally only focused on AD, small clinical samples, or grouped all dementia subtypes together, limiting insights for other ADRD subtypes. The objective of this study was to generate evidence related to the relative burden of suicidal behaviors (suicidal ideation and suicide attempt) among people with AD and ADRDs. This retrospective cross-sectional study identified hospitalizations related to suicidal behaviors (suicidal ideation and suicide attempt) for patients with Alzheimer’s disease (AD) and AD-related dementias using ICD-10-CM codes from the Nationwide Readmissions Database (NRD). A logistic regression model was estimated to assess associations between AD/ADRD subtype and patient characteristics, and the risk for a suicidal-behavior-related hospitalization and modes of harm were reported. During 2016–2018, there were 12,538 hospitalizations related to suicidal behaviors for people with AD/ADRDs. The overall prevalence of suicidal-behavior-related hospitalizations was lowest for AD (0.8%) and highest for frontotemporal dementia (2.6%). Among hospitalizations for suicide attempts, the most common mode of harm was medications or drugs (89.2% of all attempts), followed by weapons (17.7%). We found that there was a difference in the frequency of suicidal-behavior-related hospitalizations among AD/ADRD hospitalized patients across dementia subtypes.

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Should Artificial Intelligence Play a Role in Cultivating Social Connections Among Older Adults?

2023

AMA Journal of Ethics

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This article draws on 4 case studies from our group's research on older adults living alone in the United States and suggests how artificial intelligence (AI) applications can be used to foster meaningful social connections. This article also warns against ways in which AI applications can reduce physical connections and suggests how AI technology should be implemented to avoid this drawback.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity. Artificial Intelligence and ConnectionIn health care, artificial intelligence (AI) can be used to achieve specific goals (eg, detecting falls) yet allow patients some autonomy by analyzing their environments (eg, databases of videos or text) and taking specific actions. 1 Here, we aim to contribute to the conversation on the most effective pathways for AI to cultivate social connections with the goal of reducing social isolation and loneliness-2 conditions detrimental to our health. 2,3 Isolation is more quantitative, with a paucity of meaningful social contact measured in terms of network size and community involvement. 4,5,6 Loneliness is more subjective; its traditional definition is "a discrepancy between the actual and desired interaction with others." 6 We assume that these "others" are physical and human beings. Our assumption is based on evidence that our well-being is promoted by social connections with other human beings. 7,8 Although living alone does not automatically imply that someone is either socially isolated or lonely, 9 living alone can hamper efforts to maintain a rich social life, especially in old age; in developed countries, over half of women 80 years of age and older live alone. 10,11 Barriers to connecting with others in old age range from death of partners and friends to having less stamina to organize outings while managing the household alone. 12 As a result, older adults are at high risk of dying by suicide. 13 In the United States, older adults have the highest suicide rate, with older White men having a suicide rate 4 times the national rate 14 and older patients with a recent diagnosis of dementia also being at increased risk of dying by suicide. 15,16,17

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Suicide risk in first year after dementia diagnosis in older adults

Cited by 43 publications

References 52 publications

Suicide among Older Adults with Dementia: Effects of Korea’s Long-Term Care Insurance System

Suicide among Older Adults with Dementia: Effects of Korea’s Long-Term Care Insurance System

Suicidal Ideation and Suicide-Attempt-Related Hospitalizations among People with Alzheimer’s Disease (AD) and AD-Related Dementias in the United States during 2016–2018

Should Artificial Intelligence Play a Role in Cultivating Social Connections Among Older Adults?

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