Related Experiment Video
Updated: Feb 20, 2026
Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
Published on: July 27, 2018
Suicidal ideation and behavior assessment in dementia studies: An Internet survey
Phillip Chappell1, Sarah Dubrava1, Michelle Stewart1
1Pfizer, Groton, CT, USA.
Introduction:
The AARR task force on suicidal ideation and behavior (SI/SB) in dementia conducted an online survey on the extent of SI/SB in individuals diagnosed with mild cognitive impairment (MCI) or dementia who were participating in clinical trials.
Methods:
Investigators with experience in conducting SI/SB assessments in clinical trial subjects with MCI or dementia were invited to complete a global 19-item online survey.
Results:
A total of 204 evaluable responses were collected with the majority from North America and Europe (83.4%) and the remainder from Asia, Latin America, and Mideast/Africa. The mean (SD) number of subjects personally assessed by the respondents in the past year with MCI, mild-moderate dementia, or severe dementia was 12.8 (26.2), 31.2 (39.6), and 10.1 (34.7), respectively. The mean number of subjects in each diagnostic group with suicidal ideation (SI), suicidal behavior (SB), or completed suicide (CS) was on average quite low (0.3 to 1.1 for SI, 0.1 to 0.2 for SB, and 0.0 to 0.2 for CS). Confidence in subject self-reports of SI/SB over different time periods declined with increasing severity of cognitive impairment and with increasing duration of the recall time period assessed. Of respondents, 56% and 75% had low confidence in self-ratings of SI/SB from subjects with severe dementia over the past 24 hours and the past week to 1 month, respectively. Ratings of the reliability of information collected on SI/SB also decreased with increasing severity of cognitive impairment. Approximately 70% of respondents rated the reliability of the information they obtained from all sources (patient, caregiver, and others) for subjects with MCI as high, but only about half (42.0% to 55.3%) and less than a quarter (17.4% to 24.3%) rated the reliability of information obtained for subjects with mild to moderate dementia or severe dementia as high, respectively.
Discussion:
These results support the usefulness of prospective SI/SB assessments in MCI and mild dementia, raise questions about the reliability of assessments in moderate dementia, and confirm their lack of clinical utility in severe dementia. The results highlight the need for development of validated assessment instruments adapted to the stage of cognitive decline of the patients under study and may be the most effective in the earliest stages of the disease.
Insights
Suicidal ideation and behavior assessments are useful in mild cognitive impairment and mild dementia but less reliable in severe dementia. Validated instruments are needed for accurate assessment at earlier disease stages.
Area of Science:
- Neuroscience
- Gerontology
- Clinical Psychology
Background:
- The AARR task force surveyed clinicians on suicidal ideation and behavior (SI/SB) in individuals with mild cognitive impairment (MCI) or dementia in clinical trials.
- Assessing SI/SB in this population is crucial for patient safety and effective trial design.
Purpose of the Study:
- To determine the extent of SI/SB in individuals with MCI or dementia participating in clinical trials.
- To evaluate the reliability and confidence in SI/SB assessments across different stages of cognitive decline.
Main Methods:
- An online survey was administered to investigators experienced in SI/SB assessments in MCI and dementia clinical trial subjects.
- The survey collected data on the number of subjects assessed, the prevalence of SI/SB, and the confidence and reliability of these assessments.
Main Results:
- While the average reported SI/SB rates were low, confidence in self-reports and the reliability of collected information decreased significantly with increasing dementia severity.
- Approximately 70% of respondents rated information reliability as high for MCI patients, compared to less than a quarter for severe dementia patients.
Conclusions:
- Prospective SI/SB assessments are valuable in MCI and mild dementia, but their reliability is questionable in moderate to severe dementia.
- There is a critical need for validated assessment instruments tailored to the specific cognitive stage of patients to ensure accurate SI/SB evaluation.
