Dementia subtypes and suicidality: A systematic review and meta-analysis

Aims: Recent research has highlighted a link between dementia and increased risk of suicidal ideation, suicide attempts and suicide deaths. Understanding the relative risk of suicide between subtypes of dementia is important for services to offer appropriate intervention. Method: We searched five databases from inception to July 2023 for peer-reviewed publications reporting suicidal ideation, suicide attempt or death by suicide for at least two dementia subtypes. Meta-analyses compared suicidality between subtypes of dementia with Alzheimer's Disease (AD). Results: From 4983 studies identified, 12 met inclusion criteria. Pooling data, people with Vascular Dementia were significantly more likely to experience suicidal ideation (OR= 2.02 [95 % CI= 1.06;3.8]) and attempt suicide (OR=1.94 [95 % CI= 1.28;2.94]) than people with AD, but not die by suicide (OR= 1.05 [95 % CI= 0.69;1.59]). People with Dementia with Lewy Bodies were significantly more likely to report suicidal ideation (OR= 1.56 [95 % CI= 1.09;2.23]) than AD but not attempt suicide (OR= 1.12 [95 % CI= 0.83;1.50]). People with Frontotemporal Dementia were significantly more likely to attempt suicide (OR= 2.42 [95 % CI= 1.02;5.72]) than people with AD but not report suicidal ideation (OR= 1.67 [95 % CI= 0.34;8.33]). People with Mixed Dementia were significantly more likely to attempt suicide (OR= 2.83 [95 % CI= 1.52;5.27]) than people with AD but not report suicidal ideation (OR = 1.65 [95 % CI= 0.5;5.46]). Conclusions: Further research is needed to understand what underlies the increased risks of suicidal ideation and suicide attempts for rarer subtypes.