Erlangsen Annette, Zarit Steven H, Conwell Yeates
National Centre for Register-based Research, University of Aarhus, Denmark.
Am J Geriatr Psychiatry. 2008 Mar;16(3):220-8. doi: 10.1097/JGP.0b013e3181602a12.
The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders.
Event-history analysis using time-varying covariates.
Population-based record linkage.
All individuals aged 50+ living in Denmark (N=2,474,767) during January 1, 1990 through December 31, 2000.
Outcome of interest is suicide. Relative risks are calculated based on person-days spent in each stratum.
A total of 18,648,875 person-years were observed during the 11-year study period. During this period, 136 persons who previously had been diagnosed with dementia died by suicide. Men and women aged 50-69 years with hospital presentations of dementia have a relative suicide risk of 8.5 (95% confidence interval: 6.3-11.3) and 10.8 (95% confidence interval: 7.4-15.7), respectively. Those who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men and 14% of the women who died by suicide died within the first 3 months after being diagnosed whereas 38% of the men and 41% of the women died more than 3 years after initial dementia diagnosis.
Dementia, determined during hospitalization, was associated with an elevated risk of suicide for older adults. Preventive measures should focus on suicidal ideation after initial diagnosis but also acknowledge that suicides can occur well after a dementia diagnosis has been established.
本研究旨在探讨住院期间被诊断为痴呆症的患者的自杀风险及其与情绪障碍的关系。
使用时变协变量的事件史分析。
基于人群的记录链接。
1990年1月1日至2000年12月31日期间居住在丹麦的所有50岁及以上的个体（N = 2,474,767）。
感兴趣的结果是自杀。相对风险根据在每个分层中度过的人天数计算。
在11年的研究期间共观察到18,648,875人年。在此期间，136名先前被诊断为痴呆症的人自杀死亡。50 - 69岁因痴呆症住院的男性和女性的相对自杀风险分别为8.5（95%置信区间：6.3 - 11.3）和10.8（95%置信区间：7.4 - 15.7）。70岁及以上患有痴呆症的人自杀风险比没有痴呆症的人高两倍。诊断后不久的时间段与自杀风险升高有关。在控制情绪障碍时，痴呆症患者的风险仍然显著。自杀死亡的男性中有26%，女性中有14%在被诊断后的前3个月内死亡，而男性中有38%，女性中有41%在最初诊断为痴呆症3年后死亡。
住院期间确定的痴呆症与老年人自杀风险升高有关。预防措施应侧重于初始诊断后的自杀意念，但也应认识到自杀可能在痴呆症诊断确立后很长时间发生。
