1 in 10 people with dementia experience suicidal thoughts, research shows

People with dementia are more likely to have suicidal thoughts, but their chances of committing suicide or dying are not necessarily higher than the general population, a new study led by researchers from UCL has found.

The study, published in Aging Research Reviewsanalyzed 54 studies examining various aspects of mental health, including the prevalence and risk of suicide, in people with dementia, between 1991 and 2023.

Dementia is a growing global health challenge, affecting an estimated 55 million people worldwide. In addition to its impact on cognitive abilities, people with dementia often experience debilitating neurological and psychological symptoms such as depression, apathy, aggression and anxiety.

These symptoms can sometimes lead to increased emotional distress and in some cases to suicidal thoughts.

The researchers pooled data from 20 studies reporting on suicidal thoughts in people with dementia, involving more than 1.5 million people. They found that 10% of people with dementia had experienced suicidal thoughts, compared with the World Health Organization estimate of 2% for the general population.

People with moderate dementia were at greater risk of suicidal thoughts than people with mild dementia.

However, after examining data from more than 3.7 million people with dementia, researchers found that the prevalence of suicide attempts or death by suicide was about the same as the prevalence in the general population: 0.8% of people with dementia attempted suicide within a two-year period.

The team found that 0.1% of people with dementia committed suicide. Younger people with dementia were about three times more likely to be affected than older people.

Although men were less likely to report suicidal thoughts, they were significantly more likely to attempt suicide and nearly three times more likely to die by suicide than women.

Lead author, Dr Roopal Desai (UCL Psychology & Language Sciences), said: “Dementia is a growing global health problem as more people reach old age to develop it.

“People with dementia may be at increased risk of suicidal thoughts and certain groups in particular, such as men and younger people with dementia, may be at increased risk of dying by suicide, but this area is not well researched. Current NICE guidelines for the assessment, treatment and support of people with dementia do not mention suicidality in this population or how this risk should be assessed or managed. This means that clinicians are not routinely assessing or actively managing this risk.

“This review highlights the importance of providing mental health care and suicide prevention in dementia care, with an emphasis on age, symptom severity and gender.”

Based on the study’s findings, the researchers urge physicians and caregivers to closely monitor the emotional well-being of people with dementia to provide timely support and ensure patient safety.

Senior author, Dr Amber John said: “It is often assumed that suicide is not a problem in people with dementia. This study shows that people with dementia are no less likely to attempt or die from suicide than the general population, and may even be more likely to experience suicidal thoughts.

“This means that the risk of suicide in people with dementia should be taken as seriously as in the general population.”

Prof Alberto Salmoiraghi, Medical Director of Mental Health at Betsi Cadwaladr University Health Board (BCUHB), co-author of the paper, said: “These findings are really important for clinicians and crucial for future developments in service provision, particularly in relation to risk assessments and care pathways.”

Limitations of the study

The study examined different ways in which people expressed suicidal thoughts, and included both clinical and community samples, which could affect incidence rates.

Furthermore, the researchers were unable to analyze all risk factors for suicide due to a lack of information from existing studies.

Furthermore, the findings do not account for different subtypes of dementia (for example, frontotemporal dementia may carry a higher risk of suicide due to behavioral changes and aggression).