Serafini Gianluca, Calcagno Pietro, Lester David, Girardi Paolo, Amore Mario, Pompili Maurizio
Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital 1039, Via di Grottarossa, 1037, 00189 Rome, Italy.
Curr Alzheimer Res. 2016;13(10):1083-99. doi: 10.2174/1567205013666160720112608.
Suicidal behavior is a common cause of death in the elderly and is often accompanied in this population by disabilities and psychosocial impairment. Alzheimer's-related neuropathological changes are commonly found in the brains of older people. Although Alzheimer's disease (AD) has been reported to be a potential predictor for suicidal behavior, the relationship between suicidal behavior and AD has not been systematically explored. The aim of this paper is to review the current literature regarding the association between suicide risk and AD in an effort to identify the most relevant risk and protective factors for suicide. A detailed strategy was used to search for relevant articles in Pubmed, Scopus, PsycINFO, and Science Direct on suicidal behavior and AD for the period of January 1980 to August 2015. The search yielded 164 articles, of which 21 met our inclusion criteria. Eight crosssectional, two longitudinal, 3 retrospective, and eight case reports (of 11 patients) examined the association between suicide risk and AD. Suicide occurs in AD even many years after the diagnosis of dementia, and patients who have attempted suicide once are at a higher risk of dying from suicide. AD is associated with a moderate risk of suicide, and clinicians working with AD patients should undertake an appropriate assessment of their suicidal risk. However, more prospective studies are needed to clarify the association between AD and suicide risk.
自杀行为是老年人常见的死亡原因，且在这一人群中常伴有残疾和社会心理障碍。与阿尔茨海默病相关的神经病理变化在老年人脑中普遍存在。尽管已有报道称阿尔茨海默病（AD）是自杀行为的一个潜在预测因素，但自杀行为与AD之间的关系尚未得到系统探究。本文旨在综述当前关于自杀风险与AD之间关联的文献，以确定与自杀最相关的风险因素和保护因素。我们采用了详细的检索策略，在Pubmed、Scopus、PsycINFO和Science Direct数据库中检索1980年1月至2015年8月期间关于自杀行为和AD的相关文章。检索结果为164篇文章，其中21篇符合我们的纳入标准。八篇横断面研究、两篇纵向研究、三篇回顾性研究以及八篇（涉及11名患者的）病例报告对自杀风险与AD之间的关联进行了研究。即使在痴呆诊断多年后，AD患者仍会出现自杀情况，且有过一次自杀未遂的患者死于自杀的风险更高。AD与中度自杀风险相关，治疗AD患者的临床医生应适当评估其自杀风险。然而，需要更多前瞻性研究来阐明AD与自杀风险之间的关联。
