Dementia and suicide

The relationship between suicide and dementia has not systematically been i nvestigated, although the prevalence of both, dementia and suicide, increas es with age. In contrast to patients with other psychiatric disorders, pati ents with dementia were not found to die from suicide more often than expec ted (SMR, 0). Thus the diagnosis of dementia does not contribute to the ele vated suicide risk in old age. In studies using the psychological autopsy m ethod, dementia was rarely diagnosed in suicide victims. Suicide attempts w ere observed in less than 1 % of all patients with dementia. Depression as an important common risk factor of suicide and dementia is often found in p atients with Alzheimer's disease (0% to 86%) as well as in patients with mu lti-infarct dementia (20 % to 45 %). However major depression was found sig nificantly more often in vascular dementia than in dementia of Alzheimer ty pe. Suicidal thoughts and intents, wishes to die and feelings that life is not worth living were reported in 1 % to 42 % of all patients with dementia , especially if these patients also suffered from depression. This review c omprehensively presents the association between cognitive deficits, insight in early stages of dementia and suicidality and possible confounders which have not systematically been investigated up to now.