@article{ref1,
title="Determinants of suicidal behavior in dementia: a Swedish national register-based study",
journal="International psychogeriatrics / IPA",
year="2023",
author="Hedna, Khedidja and Sigström, Robert and Johnell, Kristina and Waern, Margda",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: To examine predictors of suicidal behavior (SB) in adults aged 75 years and above with dementia. <br><br>DESIGN: Longitudinal national register-based study. PARTICIPANTS AND SETTING: Swedish residents aged ≥75 years with dementia identified in the Swedish Dementia Registry (SveDem) between 1 January 2007 and 31 December 2017 (N = 59 042) and followed until 31 December 2018. Data were linked with numerous national registers using personal identity numbers. MEASUREMENTS: Outcomes were nonfatal self-harm and suicide. Fine and Gray regression models were used to investigate demographics, comorbidities, and psychoactive medications associated with fatal and nonfatal SB. <br><br>RESULTS: Suicidal behavior was observed in 160 persons after dementia diagnosis; 29 of these died by suicide. Adjusted sub-hazard ratio (aSHRs) for SB was increased in those who had a previous episode of self-harm (aSHR = 14.42; 95% confidence interval [CI] = 7.06-29.46), those with serious depression (aSHR = 4.33, 95%CI = 2.94-6.4), and in those born outside Sweden (aSHR = 1.53; 95% CI = 1.03-2.27). Use of hypnotics or anxiolytics was also associated with a higher risk of SB; use of antidepressants was not. Milder dementia and higher frailty score also increased risk of SB. Risk was decreased in those who received home care (aSHR = 0.52; 95%CI = 0.38-0.71) and in the oldest group (aSHR = 0.35; 95%CI = 0.25-0.49). <br><br>CONCLUSION: In addition to established targets for suicidal behavior prevention (improved identification and treatment of depression and previous self-harm), several new risk factors were suggested. There is a need for innovative public health strategies to meet the needs of older dementia patients with a foreign background. Home care may have a potential positive effect to prevent SB in people with dementia, but this needs to be further explored.<p /> <p>Language: en</p>",
language="en",
issn="1041-6102",
doi="10.1017/S1041610223000583",
url="http://dx.doi.org/10.1017/S1041610223000583"
}