Risk of suicidality is most prevalent in the early stages of dementia

Although increased life expectancy is often associated with healthy aging, it also brings a higher risk of dementia – and possibly of suicidal behavior. A large Swedish register-based study finds that individuals with dementia, particularly in the early stages following diagnosis, have an elevated risk of suicide and suicide attempts. These findings provide important insight into when and how suicide prevention efforts should be implemented.

This study analysed data over a ten-year period using the Swedish Dementia Registry, including diagnoses from both primary care and specialist clinics. These were linked with national register data on home care, medication use, psychiatric disorders, and records of suicide attempts and suicides. Thus, both clinical and social factors were included.

The results show that people with dementia have an increased risk of suicidal behavior. The risk was especially high among those with a history of psychiatric disorders or suicide attempts, those with physical health burdens, those receiving home care, and individuals born outside of Sweden. The suicide risk was particularly elevated shortly after diagnosis and declined as the disease progressed. This may be due to decreased capacity to act in later stages or the psychological response to receiving a serious diagnosis.

The risk of suicide in dementia is especially high in the early stages. Therefore, preventive efforts should be directed at individuals newly diagnosed with dementia. Providing information about the disease trajectory and supporting autonomy in primary care may be key strategies to reduce psychological distress and suicidal behavior.