Suicide in dementia: 9-year national clinical survey in England and Wales

Background Knowledge of suicide in people with dementia is limited to small case series. Aims To describe behavioural, clinical and care characteristics of people with dementia who died by suicide. Method Ail dementia cases (n=l18) from a 9-year national clinical survey of suicides in England and Wales (n=1l 512) were compared with age- and gender-matched non-dementia cases (control group) (n=492) by conditional logistic regression. Results The most common method of suicide in patients with dementia was self-poisoning, followed by drowning and hanging, the latter being less frequent than in controls. In contrast to controls, significantly fewer suicides occurred within 1 year of diagnosis in patients with dementia. Patients with dementia were also less likely to have a history of self-harm, psychiatric symptoms and previous psychiatric admissions. Conclusions Known indicators of suicide risk are found less frequently in dementia suicide cases than non-dementia suicide cases. Further research should clarify whether suicide in dementia is a response to worsening dementia or an under- appreciation of psychiatric symptoms by clinicians.