Francisco Javier Álvarez Muñoz1, María Rubio-Aparicio2, Pedro Gurillo Muñoz3, Ana María García Herrero4, Julio Sánchez-Meca5, Fernando Navarro-Mateu6. 1. Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Gerencia Regional de Salud Mental, Servicio Murciano de Salud, Murcia, España. 2. Departamento de Psicología de la Salud, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España. Electronic address: maria.rubio@ua.es. 3. Departamento de Psiquiatría, Hospital Marina Baja, Alicante, España. 4. Centro de Salud Mental Jumilla-Yecla, Servicio Murciano de Salud, Yecla, España. 5. Departamento de Psicología Básica y Metodología, Facultad de Psicología, Universidad de Murcia, Murcia, España. 6. Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Gerencia Regional de Salud Mental, Servicio Murciano de Salud, Murcia, España; Departamento de Psicología Básica y Metodología, Facultad de Psicología, Universidad de Murcia, Murcia, España; CIBER de Epidemiología y Salud Pública (CIBERESP) IMIB-Arrixaca, Murcia, España.
Abstract
INTRODUCTION: To analyse the possible relationship between dementia in the elderly and the subsequent development of suicide ideation, attempts and / or completed suicides. METHODS: Systematic review and meta-analysis. SELECTION CRITERIA: studies that analysed the relationship between dementia and suicide. SEARCH STRATEGY: i) in PubMed, EMBASE, CINAHL, IME and Lilacs until December 2018; ii) manual search of the bibliography of selected articles; iii) contact with leading authors. Article selection and data extraction according to a predefined protocol, including bias risk assessment, were performed by independent peer reviewers. The effect size index was calculated using Odds Ratio (OR) and its 95% confidence interval (random-effects model). Heterogeneity was evaluated with forest plots, Cochran's Q and I2 index. Assessment of publication bias using funnel plots ("trim-and-fill" method) and the Egger test. The analysis of moderating variables was performed using a multiple meta-regression under a mixed-effects model. RESULTS: 37 studies and 47 basic units of study were identified. Effect size of the association of dementia with: Suicidal Ideation OR = 1.37 (95% CI: .78-2.39); Suicide Attempt: OR = 2.24 (95% CI: 1.01-4.97); and Completed Suicide: OR = 1.28 (95% CI: .77-2.14). Possible publication bias was ruled out. CONCLUSIONS: A trend towards suicidal events is identified, especially suicide attempts in people with dementia. Greater attention and care are recommended after a recent diagnosis of dementia, especially with adequate assessment of comorbidities, which could influence the occurrence and outcome of suicidal events.
INTRODUCTION: To analyse the possible relationship between dementia in the elderly and the subsequent development of suicide ideation, attempts and / or completed suicides. METHODS: Systematic review and meta-analysis. SELECTION CRITERIA: studies that analysed the relationship between dementia and suicide. SEARCH STRATEGY: i) in PubMed, EMBASE, CINAHL, IME and Lilacs until December 2018; ii) manual search of the bibliography of selected articles; iii) contact with leading authors. Article selection and data extraction according to a predefined protocol, including bias risk assessment, were performed by independent peer reviewers. The effect size index was calculated using Odds Ratio (OR) and its 95% confidence interval (random-effects model). Heterogeneity was evaluated with forest plots, Cochran's Q and I2 index. Assessment of publication bias using funnel plots ("trim-and-fill" method) and the Egger test. The analysis of moderating variables was performed using a multiple meta-regression under a mixed-effects model. RESULTS: 37 studies and 47 basic units of study were identified. Effect size of the association of dementia with: Suicidal Ideation OR = 1.37 (95% CI: .78-2.39); Suicide Attempt: OR = 2.24 (95% CI: 1.01-4.97); and Completed Suicide: OR = 1.28 (95% CI: .77-2.14). Possible publication bias was ruled out. CONCLUSIONS: A trend towards suicidal events is identified, especially suicide attempts in people with dementia. Greater attention and care are recommended after a recent diagnosis of dementia, especially with adequate assessment of comorbidities, which could influence the occurrence and outcome of suicidal events.
Authors: Luis Agüera-Ortiz; Rocío García-Ramos; Francisco J Grandas Pérez; Jorge López-Álvarez; José Manuel Montes Rodríguez; F Javier Olazarán Rodríguez; Javier Olivera Pueyo; Carmelo Pelegrin Valero; Jesús Porta-Etessam Journal: Front Psychiatry Date: 2021-02-26 Impact factor: 4.157