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A Complex Relationship Between Suicide, Dementia, and Amyloid: A Narrative Review
Ismael Conejero1,2,3, Sophie Navucet4, Jacques Keller4
1Department of Psychiatry, Caremeau Hospital, University Hospital of Nîmes, Nîmes, France.
Frontiers in Neuroscience
|June 19, 2018
Summary
Suicide risk increases in early dementia stages, but severe cognitive impairment may later reduce suicidal thoughts and planning. Brain amyloid load may contribute to early suicide risk.
Area of Science:
- Neuroscience
- Gerontology
- Psychiatry
Background:
- Older adults have high suicide rates, linked to chronic illnesses, disabilities, isolation, and cognitive disorders.
- The relationship between dementia and suicidal behavior is complex, with conflicting research findings.
- Key questions remain regarding Alzheimer's disease (AD) and suicide risk, early dementia signs, and amyloid's role in suicidal attempts (SA).
Purpose of the Study:
- To review recent literature on the links between suicidal behavior, dementia, and brain amyloid load.
- To explore the role of depression in these relationships.
- To clarify whether AD increases suicide risk, if suicidal ideation is an early dementia sign, and if amyloid influences SA.
Main Methods:
- A narrative review of studies published between 2000 and 2017.
- PubMed database search using MeSH terms: "Suicide" AND "Depression" OR "Amyloid" OR "Dementia".
- Exploration of clinical and pathophysiological aspects of depression.
Main Results:
- Late-stage dementia may offer protection against suicidal ideation and suicide attempts (SA).
- The risk of completed suicide appears elevated during the early stages of cognitive decline.
- Brain amyloid load might be a factor in the increased suicide rate observed early after dementia diagnosis.
Conclusions:
- Significant cognitive impairment and executive dysfunction may reduce awareness of cognitive disability and hinder suicide planning.
- Early cognitive decline is associated with an increased risk of suicide.
- Further research is needed to understand the mechanisms linking dementia, amyloid, and suicidal behavior.
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