TY - JOUR
T1 - The role of dementia and mild cognitive impairment in deaths by suicide in Australia
T2 - A retrospective study of coronial records
AU - Cooper, Maxwell
AU - Couzner, Leah
AU - Smith-Merry, Jennifer
AU - Draper, Brian
AU - Low, Lee Fay
AU - Cations, Monica
PY - 2025/1
Y1 - 2025/1
N2 - Objective: To characterise the cohort of individuals who died by suicide in two Australian states where dementia or mild cognitive impairment was implicated in the death, and to examine the themes related to their deaths. Design: Retrospective multi-methods study. Setting: Coronial data, including police and autopsy reports, held in the National Coronial Information System. Participants: All individuals who died by suicide in South Australia and New South Wales between 2011 and 2020 where dementia or mild cognitive impairment was relevant to their death (n = 152). Measurements: Descriptive quantitative analysis of demographic and clinical data, and thematic analysis of themes in autopsy and police reports. Results: Included deaths were 67 people with confirmed dementia or MCI, 24 people with suspected dementia or MCI, 56 family members/friends of people with dementia or MCI, and 5 people who cited fear of dementia as a contributing factor for their death. The cohort were majority male (62.4 %), aged 74 years on average at the time of death (standard deviation 12.5 years), married (53.9 %), and retired (74.3 %). Themes described psychological distress and existential despair related to impairments, loss of autonomy and burdensomeness, fear of future degeneration and burdening others even where dementia onset had not occurred, factors external to but related to the dementia that cause distress and burden for family members and friends (e.g. housing, legal matters), and the phenomenon of simultaneous deaths. Conclusions: Mitigation of secondary effects of dementia, as well as fear and stigma, may prevent some death by suicide.
AB - Objective: To characterise the cohort of individuals who died by suicide in two Australian states where dementia or mild cognitive impairment was implicated in the death, and to examine the themes related to their deaths. Design: Retrospective multi-methods study. Setting: Coronial data, including police and autopsy reports, held in the National Coronial Information System. Participants: All individuals who died by suicide in South Australia and New South Wales between 2011 and 2020 where dementia or mild cognitive impairment was relevant to their death (n = 152). Measurements: Descriptive quantitative analysis of demographic and clinical data, and thematic analysis of themes in autopsy and police reports. Results: Included deaths were 67 people with confirmed dementia or MCI, 24 people with suspected dementia or MCI, 56 family members/friends of people with dementia or MCI, and 5 people who cited fear of dementia as a contributing factor for their death. The cohort were majority male (62.4 %), aged 74 years on average at the time of death (standard deviation 12.5 years), married (53.9 %), and retired (74.3 %). Themes described psychological distress and existential despair related to impairments, loss of autonomy and burdensomeness, fear of future degeneration and burdening others even where dementia onset had not occurred, factors external to but related to the dementia that cause distress and burden for family members and friends (e.g. housing, legal matters), and the phenomenon of simultaneous deaths. Conclusions: Mitigation of secondary effects of dementia, as well as fear and stigma, may prevent some death by suicide.
KW - Death and dying, family carers
KW - Dementia
KW - Suicide
UR - http://www.scopus.com/inward/record.url?scp=85218435476&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1194084
U2 - 10.1016/j.inpsyc.2024.100002
DO - 10.1016/j.inpsyc.2024.100002
M3 - Article
C2 - 39924273
AN - SCOPUS:85218435476
SN - 1041-6102
VL - 37
JO - International Psychogeriatrics
JF - International Psychogeriatrics
IS - 1
M1 - 100002
ER -
