Risk factors for dementia and self-harm: A linkage study.
dementia
hospital admissions
linked data
mental health
self-harm
Journal
Alzheimer's & dementia : the journal of the Alzheimer's Association
ISSN: 1552-5279
Titre abrégé: Alzheimers Dement
Pays: United States
ID NLM: 101231978
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
22
02
2023
received:
12
12
2022
accepted:
11
03
2023
medline:
16
11
2023
pubmed:
1
5
2023
entrez:
1
5
2023
Statut:
ppublish
Résumé
People living with dementia experience poor mental health and high rates of self-harm. We investigated risk factors for self-harm in people aged > 40 years living with dementia and risk factors for dementia after self-harm. Using linked hospital data from New South Wales, Australia, we defined a dementia cohort (n = 154,811) and a self-harm cohort (n = 28,972). Using survival analyses, we investigated predictors of self-harm for the dementia cohort, and predictors of dementia for the self-harm cohort. We found self-harm or dementia diagnoses occurred most often within 24 months of a dementia diagnosis or initial self-harm presentation, respectively. Men living with dementia, and people with complex psychiatric profiles, had the greatest risk of self-harm. Men who had self-harmed had the greatest risk of dementia diagnoses. Men and people with complex psychiatric profiles and dementia may particularly benefit from post-diagnosis mental and behavioral support to reduce risk of self-harm.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
5138-5150Informations de copyright
© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.
Références
Alzheimer's association. 2021 Alzheimer's disease facts and figures. Alzheimers Dement. 2021;17:327-406.
Australian Institute of Health Welfare. Dementia. Canberra. AIHW; 2020.
Cao Q, Tan C-C, Xu W, et al. The prevalence of dementia: a systematic review and meta-analysis. J Alzheimers Dis. 2020;73:1157-1166.
Brown MT, Wolf DA. Estimating the prevalence of serious mental illness and dementia diagnoses among Medicare beneficiaries in the health and retirement study. Res Aging. 2018;40:668-686.
Kuring J, Mathias J, Ward L. Prevalence of depression, anxiety and PTSD in people with dementia: a systematic review and meta-analysis. Neuropsychol Rev. 2018;28:393-416.
Mitchell R, Draper B, Harvey L, Brodaty H, Close J. The survival and characteristics of older people with and without dementia who are hospitalised following intentional self-harm. Int J Geriatr Psychiatry. 2017;32:892-900.
Wand APF, Peisah C, Draper B, Brodaty H. Why do the very old self-harm? a qualitative study. Am J Geriatr Psychiatry. 2018;26:862-871.
Draper B. Self-harm in late life and subsequent risk of dementia. Am J Geriatr Psychiatry. 2016;24:1219-1220.
Gujral S, Butters MA, Dombrovski AY, Szanto K. Late-onset suicide: a dementia prodrome? Am J Geriatr Psychiatry. 2021;29:709-713.
Kaup AR, Byers AL, Falvey C, et al. Trajectories of depressive symptoms in older adults and risk of dementia. JAMA Psychiatry. 2016;73:525-531.
Draper BM. Suicidal behavior and assisted suicide in dementia. Int Psychogeriatr. 2015;27:1601-1611.
Bennett S, Thomas AJ. Depression and dementia: cause, consequence or coincidence? Maturitas. 2014;79:184-190.
Reppermund S, Heintze T, Srasuebkul P, et al. Health and wellbeing of people with intellectual disability in New South Wales, Australia: a data linkage cohort. BMJ Open. 2019;9:e031624.
Australian Institute of Health and Welfare. People with dementia in hospitals in New South Wales 2006-07. AIHW; 2012.
Gauthier S, Reisberg B, Zaudig M, et al. Mild cognitive impairment. Lancet North Am Ed. 2006;367:1262-1270.
Chandler J, Kubisiak J. Clinical and economic assessment in early-stage dementia by severity and amyloid-β status: a 5-year retrospective claims study of GERAS-US patients. J Alzheimers Dis. 2023;91:753-765.
Chan DC, Kasper JD, Black BS, Rabins PV. Prevalence and correlates of behavioral and psychiatric symptoms in community-dwelling elders with dementia or mild cognitive impairment: the Memory and Medical Care Study. Int J Geriatr Psychiatry. 2003;18:174-182.
Ganguli M, Jia Y, Hughes TF, et al. Mild cognitive impairment that does not progress to dementia: a population-based study. J Am Geriatr Soc. 2019;67:232-238.
Australian Institute of Health and Welfare. Suicide & self-harm monitoring. https://www.aihw.gov.au/suicide-self-harm-monitoring/data/technical-notes/codes-and-classifications2021
Chitty KM, Cvejic RC, Heintze T, et al. The association between problematic use of alcohol and drugs and repeat self-harm and suicidal ideation. Crisis. 2022.
Australian Bureau of Statistics. Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2016. https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2033.0.55.001~2016~Main%20Features~IRSD~192018
Australian Bureau of Statistics. Australian Statistical Geography Standard (ASGS): Volume 5 - Remoteness Structure, 2016. https://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/1270.0.55.005Main%20Features1July%202016?opendocument&tabname=Summary&prodno=1270.0.55.005&issue=July%202016&num=&view=2018
Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998;36:8-27.
Royston P, Lambert PC. Flexible parametric survival analysis using Stata: beyond the Cox model. Stata press; 2011.
Cheung YB, Gao F, Khoo KS. Age at diagnosis and the choice of survival analysis methods in cancer epidemiology. J Clin Epidemiol. 2003;56:38-43.
Lipsky AM, Greenland S. Causal directed acyclic graphs. JAMA. 2022;327:1083-1084.
Westreich D, Greenland S. The table 2 fallacy: presenting and interpreting confounder and modifier coefficients. Am J Epidemiol. 2013;177:292-298.
Greenland S, Pearl J, Robins JM. Causal diagrams for epidemiologic research. Epidemiology. 1999;10(1):37-48.
R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing; 2021.
StataCorp. Stata Statistical Software: Release 17. StataCorp LLC.; 2021.
SAS Institute Inc. SAS 9.4 Cary. 2016.
Textor J, van der Zander B, Gilthorpe MS, Liśkiewicz M, Ellison GT. Robust causal inference using directed acyclic graphs: the R package ‘dagitty. Int J Epidemiol. 2017;45:1887-1894.
Ferrari AJ, Norman RE, Freedman G, et al. The burden attributable to mental and substance use disorders as risk factors for suicide: findings from the Global Burden of Disease Study. PLoS One. 2010;9:e91936.
Neufeld E, Hirdes JP, Perlman CM, Rabinowitz T. Risk and protective factors associated with intentional self-harm among older community-residing home care clients in Ontario, Canada. Int J Geriatr Psychiatry. 2015;30:1032-1040.
Evans D, Lee E. Impact of dementia on marriage: a qualitative systematic review. Dementia. 2014;13:330-349.
Draper B, Peisah C, Snowdon J, Brodaty H. Early dementia diagnosis and the risk of suicide and euthanasia. Alzheimers Dement. 2010;6:75-82.
Murphy E, Kapur N, Webb R, et al. Risk factors for repetition and suicide following self-harm in older adults: multicentre cohort study. Br J Psychiatry. 2012;200:399-404.
Morgan C, Webb RT, Carr MJ, et al. Self-harm in a primary care cohort of older people: incidence, clinical management, and risk of suicide and other causes of death. Lancet Psychiatry. 2018;5:905-912.
Wand AP, Reppermund S. Longitudinal big data needs to meet the individual to inform self-harm and suicide prevention in older adults. Int Psychogeriatr. 2022;34(9):767-769.