Department of Psychiatry, Yale University, New Haven, Connecticut, USA.
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York, USA.
Alzheimers Dement. 2022 Feb;18(2):262-271. doi: 10.1002/alz.12390. Epub 2021 May 25.
Receiving a diagnosis of Alzheimer's disease or related dementias (ADRD) can be a pivotal and stressful period. We examined the risk of suicide in the first year after ADRD diagnosis relative to the general geriatric population.
We identified a national cohort of Medicare fee-for-service beneficiaries aged ≥ 65 years with newly diagnosed ADRD (n = 2,667,987) linked to the National Death Index.
The suicide rate for the ADRD cohort was 26.42 per 100,000 person-years. The overall standardized mortality ratio (SMR) for suicide was 1.53 (95% confidence interval [CI] = 1.42, 1.65) with the highest risk among adults aged 65 to 74 years (SMR = 3.40, 95% CI = 2.94, 3.86) and the first 90 days after ADRD diagnosis. Rural residence and recent mental health, substance use, or chronic pain conditions were associated with increased suicide risk.
Results highlight the importance of suicide risk screening and support at the time of newly diagnosed dementia, particularly for patients aged < 75 years.
被诊断出患有阿尔茨海默病或相关痴呆症（ADRD）可能是一个关键且充满压力的时期。我们研究了与一般老年人群相比，ADRD 诊断后第一年自杀的风险。
我们确定了一个全国性的 Medicare 按服务收费受益人群队列，年龄≥65 岁，患有新诊断的 ADRD（n=2,667,987），并与国家死亡指数相关联。
ADRD 队列的自杀率为每 100,000 人年 26.42 人。自杀的总体标准化死亡率（SMR）为 1.53（95%置信区间[CI]为 1.42，1.65），年龄在 65 至 74 岁的成年人风险最高（SMR=3.40，95%CI=2.94，3.86），并且在 ADRD 诊断后的前 90 天风险最高。农村居住和最近的心理健康、物质使用或慢性疼痛状况与自杀风险增加有关。
结果强调了在新诊断为痴呆症时进行自杀风险筛查和支持的重要性，特别是对于年龄<75 岁的患者。
