Selvmordsrisiko blandt personer diagnosticeret med demens

Abstract

Formål: Studiet undersøger risikoen for selvmord blandt personer med hospitalsdiagnosticeret demens og dets sammenhæng med depression. Data og metode: Individbaserede registerdata dækkende alle personer fyldt 50 år og derover bosat i Danmark i perioden 1. januar 1990 til 31. december 2000 (N = 2.474.767) blev analyseret. Eventhistory analyseteknik blev benyttet til at beregne relative risiko for død af selvmord i multivariable analyser. Resultat: I alt 18.648.875 personår blev observeret over det 11-årige studieforløb. Der forekom 136 selvmord blandt personer med demens diagnosticeret ved hospitalsindlæggelse. Den relative risiko for selvmord blandt mænd og kvinder i alderen 50–69 år med demens var henholdsvis 8,5 [CI-95%: 6,3–11,3] og 10,8 [CI-95%:7,4–15,7]. Personer fyldt 70 år og derover med demensdiagnoser havde en tre gange højere selvmordsrisiko end personer uden demens. Den forhøjede selvmordsrisiko blandt personer med demens forblev signifikant også efter justering for depressionsdiagnoser. Henholdsvis 40% og 38% af selvmord blandt mænd og kvinder med demens fandt sted inden for det første år efter demensdiagnosen første gang blev konstateret. Konklusion: Demens, defineret som diagnosticeret ved hospitalsindlæggelse, var forbundet med en højere selvmordsrisiko for personer fyldt 50 år og derover. Særligt tiden efter første diagnose og dobbeltdiagnose med depression korrelerede med en forhøjet risiko for selvmord. Objective: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. Data and method: Individual-level register data on all persons aged 50+ living in Denmark during January 1, 1990 through December 31, 2000 (N = 2,474,767) were included in the analysis. Event-history analysis was applied to calculate relative risks of dying by suicide while controlling for select timevarying covariates Results: A total of 18,648,875 personyears were observed during the 11-year study period. During this period, 136 persons who previously were diagnosed with dementia died by suicide. Men and women aged 50–69 years with hospital presentations of dementia had a relative suicide risk of 8.5 [CI-95%: 6.3–11.3] and 10.8 [CI-95%:7.4–15.7], respecti-vely. Those who aged 70 or older with dementia had a threefold higher risk than persons with no dementia. The risk among persons with dementia remained significant when controlling for diag-noses of mood disorders. As many as 40% of the men and 38% of the women who died by suicide died within the first year after initial dementia diagnosis. Conclusions: Dementia, determined during hospitalization, was associated with an elevated risk of suicide for older adults. Particularly, time shortly after initial diagnosis and presence of mood disorders was found to correlate with an increased risk of suicide.