Dementia diagnosis increases self-harm risk in first year

Key takeaways:

• Dementia diagnoses or self-harm most frequently occurred within 24 months of the other.
• Diagnosis of dementia was associated with greater risk for self-harm in the first 6 to 12 months after diagnosis.

Most self-harm diagnoses occurred within 24 months of a dementia diagnosis, and vice versa, with a greater risk for self-harm within 6 to 12 months after dementia diagnosis, according to findings published in Alzheimer’s & Dementia.

Adrian R. Walker, PhD, a research fellow at the University of New South Wales Centre for Big Data Research in Health in Sydney, Australia, and colleagues analyzed linked data from the Admitted Patient Data Collection, the ED Data Collection, the Mental Health Ambulatory Data Collection, the New South Wales (NSW) Registry of Births, Death and Marriages and the NSW Cause of Death Unit Record File.

These datasets were used to identify 154,811 people who had no history of self-harm who were diagnosed with dementia between July 2001 and December 2014 — termed the dementia cohort — and 28,972 people who had no history of dementia who were diagnosed with self-harm between January 2005 and December 2014 — termed the self-harm cohort.

The researchers identified predictors of self-harm in the dementia cohort and predictors of dementia in the self-harm cohort.

Among those in the dementia cohort, 652 people were later diagnosed with self-harm, while 870 people in the self-harm cohort were later diagnosed with dementia. These second diagnoses frequently occurred within 24 months of the first, with 60.9% of the dementia cohort and 51.3% of the self-harm cohort receiving their self-harm and dementia diagnoses, respectively, during that time.

In both the dementia and self-harm cohorts, men were more likely to be diagnosed with self-harm or dementia, respectively, compared with women.

“Generally, women tend to be over-represented in people diagnosed with dementia, as well as people who self-harm, compared to men,” Walker said in a press release. “The fact that there are more men at the intersection of self-harm and dementia is concerning, though we should also be careful not to forget the substantial number of women living with dementia who self-harm.”

Additionally, people in the dementia cohort were more likely to self-harm if they were partnered, had used ambulatory mental health services, had anxiety, behavioral issues or a personality disorder. Among people in the self-harm cohort, dementia diagnosis was associated with not being partnered, having a psychotic disorder, having behavioral issues or having delirium.

“Our results highlight the need for better mental health and behavioral supports soon after dementia diagnosis or self-harm in older people, echoing earlier recommendations,” Walker and colleagues wrote. “For people recently diagnosed with dementia, the first 6 to 12 months after diagnosis (when cognitive functioning may still be relatively high) constitute a critical window to provide supports for people living with dementia.”

References:

• Dementia and self-harm: why it's crucial to support patients in first year after diagnosis. https://www.eurekalert.org/news-releases/988079. Published May 2, 2023. Accessed May 12, 2023.
• Walker AR, et al. Alzheimers Dement. 2023;doi:10.1002/alz.13080.