Suicide attempts and associated factors in patients with dementia: A 7-year population-based cohort study in Taiwan

Patients with dementia are at elevated risk of suicide attempts, yet evidence on associated risk factors remains limited, especially in Asian populations. This study examined the associations between sociodemographic and clinical factors and the risk of suicide attempt-related hospitalization among dementia patients in Taiwan over a 7-year period, considering death as a competing risk.

A total of 266,590 patients aged ≥40 years with newly diagnosed dementia (2009-2014) were identified from Taiwan's National Health Insurance Research Database and followed until their first hospitalization for a suicide attempt, death, or the end of 2015. Cause-specific hazard models assessed sociodemographic and clinical factors associated with overall and sex-specific risks.

The overall incidence density (ID) of hospitalization for suicide attempts was 1.81 per 1000 person-years (95 % CI: 1.72-1.90), with the highest ID observed within the first year following the initial dementia diagnosis, irrespective of sex. Male sex, older age, lower income, major depressive disorder, bipolar disorders, other psychiatric conditions, higher Charlson Comorbidity Index scores, and more frequent outpatient visits were all significantly associated with an increased risk of suicide attempt-related hospitalization. Stratified analyses revealed sex-specific differences in the influence of these associated factors.

Patients with dementia who are at increased risk of suicide attempt-related hospitalization may exhibit differing patients' characteristics. Effective prevention strategies should consider both the timing following dementia diagnosis and sex-specific risk profiles to better address suicide attempt risks in this vulnerable population.