{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T15:22:14Z","timestamp":1774624934046,"version":"3.50.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Background and Objectives:<\/jats:bold> Data on suicidal ideation, behavior and the risk factors in patients with dementia is scarce. To evaluate the prevalence of death wishes, suicidal ideation, and suicidal behavior of young (YOD) and late onset dementia (LOD) and to identify risk factors for suicidal ideation and behavior.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We interviewed 157 family caregivers of patients with advanced dementia using questions from the Columbia-Suicide Severity Rating Scale to gather information about suicidal ideation and behavior before the onset of symptoms of dementia, after the onset of dementia and within 30 days prior to the interview. At the time of the interview, we also assessed disease severity, cognitive function, and other psychological, behavioral and physical symptoms of the patients as well as the caregivers' psychological well-being.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Forty four (28%) of the patients expressed suicidal ideation or behavior at some time after the onset of symptoms, and 14 (9%) of these within the month prior to the assessment. Two patients had attempted suicide after the onset of dementia. There were no statistically significant differences between patients with and without suicidal ideations or behavior with regards to demographics or age at onset of dementia. In patients with advanced dementia, Alzheimer's disease (rather than frontotemporal lobar degeneration), better cognitive function, more severe psychological, behavioral, and physical symptoms, and a reduced quality of life were associated with the expression of suicidal ideation.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> According to caregivers' reports, majority of patients with dementia did not express suicidal ideation or show suicidal behavior. Patients who expressed suicidal ideation during early stages of dementia often stopped expressing them in advanced stages. It remains unclear if this was due to reduced communication abilities, a reduction of disease awareness, and\/ or an adjustment to their situation.<\/jats:p>","DOI":"10.3389\/fneur.2021.647396","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T08:57:00Z","timestamp":1627376220000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Suicidal Ideations and Behavior in Patients With Young and Late Onset Dementia"],"prefix":"10.3389","volume":"12","author":[{"given":"Marion","family":"Ortner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Riedl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf J.","family":"Jox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carola","family":"Ro\u00dfmeier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Dorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Kehl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Egert-Schwender","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janine","family":"Diehl-Schmid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,27]]},"reference":[{"key":"B1","volume-title":"Suicidal Ideation","author":"Harmer","year":"2021"},{"key":"B2","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1146\/annurev-clinpsy-021815-093204","article-title":"Suicide, suicide attempts, and suicidal ideation","volume":"12","author":"Klonsky","year":"2016","journal-title":"Annu Rev Clin Psychol."},{"key":"B3","unstructured":"Suicide2021"},{"key":"B4","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1027\/0227-5910\/a000350","article-title":"Active and passive suicidal ideation in older prisoners","volume":"37","author":"Barry","year":"2016","journal-title":"Crisis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1037\/0022-006X.47.2.343","article-title":"Assessment of suicidal intention: the scale for suicide ideation","volume":"47","author":"Beck","year":"1979","journal-title":"J Consult Clin Psychol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1176\/appi.ajp.2011.10111704","article-title":"The Columbia-suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults","volume":"168","author":"Posner","year":"2011","journal-title":"Am J Psychiatry."},{"key":"B7","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1093\/ageing\/27.4.503","article-title":"Suicidal ideation and the 'wish to die' in dementia patients: the role of depression","volume":"27","author":"Draper","year":"1998","journal-title":"Age Ageing."},{"key":"B8","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1177\/089198870201500108","article-title":"Life is not worth living: hopelessness in Alzheimer's disease","volume":"15","author":"Harwood","year":"2002","journal-title":"J Geriatr Psych Neur"},{"key":"B9","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.jad.2015.02.019","article-title":"Suicidal ideation and related factors among dementia patients","volume":"178","author":"Koyama","year":"2015","journal-title":"J Affect Disord."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2308","DOI":"10.1212\/WNL.44.12.2308","article-title":"The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia","volume":"44","author":"Cummings","year":"1994","journal-title":"Neurology."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1176\/ajp.146.8.1017","article-title":"Psychopathology of very mild dementia of the Alzheimer type","volume":"146","author":"Rubin","year":"1989","journal-title":"Am J Psychiatry."},{"key":"B12","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1017\/S1041610209009065","article-title":"Dementia and suicidal behavior: a review of the literature","volume":"21","author":"Haw","year":"2009","journal-title":"Int Psychogeriatr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1097\/JGP.0b013e3181bd1c13","article-title":"Attempted suicide in the elderly: characteristics of suicide attempters 70 years and older and a general population comparison group","volume":"18","author":"Wiktorsson","year":"2010","journal-title":"Am J Geriatr Psychiatry."},{"key":"B14","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1177\/0891988718814363","article-title":"Suicide among persons with dementia, Georgia, 2013 to 2016","volume":"32","author":"Annor","year":"2019","journal-title":"J Geriatr Psychiatry Neurol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1159\/000064931","article-title":"Suicide amongst Alzheimer's disease patients: a 10-year survey","volume":"14","author":"Barak","year":"2002","journal-title":"Dement Geriatr Cogn Disord."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1002\/gps.1795","article-title":"Chinese demented inpatients admitted following a suicide attempt: a case series","volume":"22","author":"Tsai","year":"2007","journal-title":"Int J Geriatr Psychiatry."},{"key":"B17","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.jalz.2011.01.006","article-title":"Predictors of suicide in patients with dementia","volume":"7","author":"Seyfried","year":"2011","journal-title":"Alzheimers Dement."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1016\/j.jpsychires.2011.06.002","article-title":"The impact of psychiatric illness on suicide: differences by diagnosis of disorders and by sex and age of subjects","volume":"45","author":"Qin","year":"2011","journal-title":"J Psychiatr Res."},{"key":"B19","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1192\/bjp.bp.108.050500","article-title":"Suicide in dementia: 9-year national clinical survey in England and Wales","volume":"194","author":"Purandare","year":"2009","journal-title":"Br J Psychiatry."},{"key":"B20","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1055\/s-2001-12693","article-title":"Dementia and suicide","volume":"69","author":"Schneider","year":"2001","journal-title":"Fortschr Neurol Psychiatr."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.1017\/S1041610217000679","article-title":"Suicide and assisted dying in dementia: what we know and what we need to know. A narrative literature review","volume":"29","author":"Diehl-Schmid","year":"2017","journal-title":"Int Psychogeriatr."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1016\/j.jagp.2018.08.012","article-title":"High occurrence of psychiatric disorders and suicidal behavior across dementia subtypes","volume":"26","author":"Lai","year":"2018","journal-title":"Am J Geriatr Psychiatry."},{"key":"B23","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.trci.2016.02.001","article-title":"Considerations for the assessment of suicidal ideation and behavior in older adults with cognitive decline and dementia","volume":"2","author":"Alphs","year":"2016","journal-title":"Alzheimers Dement."},{"key":"B24","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1186\/s12888-018-1846-0","article-title":"IssuEs in Palliative care for people in advanced and terminal stages of young-onset and late-onset dementia in Germany (EPYLOGE): the study protocol","volume":"18","author":"Diehl-Schmid","year":"2018","journal-title":"BMC Psychiatry."},{"key":"B25","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d. A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J Psychiatr Res"},{"key":"B26","doi-asserted-by":"publisher","first-page":"2412","DOI":"10.1212\/WNL.43.11.2412-a","article-title":"The Clinical Dementia Rating (CDR): current version and scoring rules","volume":"43","author":"Morris","year":"1993","journal-title":"Neurology."},{"key":"B27","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1159\/000089218","article-title":"The clinical dementia rating sum of box score in mild dementia","volume":"21","author":"Lynch","year":"2006","journal-title":"Dement Geriatr Cogn Disord."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2957","DOI":"10.1093\/brain\/awn234","article-title":"Development of methodology for conducting clinical trials in frontotemporal lobar degeneration","volume":"131","author":"Knopman","year":"2008","journal-title":"Brain."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1176\/ajp.139.9.1136","article-title":"The global deterioration scale for assessment of primary degenerative dementia","volume":"139","author":"Reisberg","year":"1982","journal-title":"Am J Psychiatry."},{"key":"B30","volume-title":"Beck Depression Inventory, 2nd edn","author":"Beck","year":"1988"},{"key":"B31","volume-title":"Wellbeing Measures in Primary Health Care\/The Depcare Project","year":"1998"},{"key":"B32","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1093\/geronj\/38.3.344","article-title":"Validation of a caregiver strain index","volume":"38","author":"Robinson","year":"1983","journal-title":"J Gerontol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1097\/00002093-200110000-00005","article-title":"Scales for evaluation of end-of-life care in dementia","volume":"15","author":"Volicer","year":"2001","journal-title":"Alzheimer Dis Assoc Disord."},{"key":"B34","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1037\/t00432-000","article-title":"The quality of life in late-stage dementia (QUALID) scale","volume":"1","author":"Weiner","year":"2000","journal-title":"J Am Med Dir Assoc."},{"key":"B35","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1176\/appi.ajp.162.4.725","article-title":"Critical periods of suicide risk in Huntington's disease","volume":"162","author":"Paulsen","year":"2005","journal-title":"Am J Psychiatry."},{"key":"B36","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1080\/21678421.2018.1530265","article-title":"Wish to die and reasons for living among patients with amyotrophic lateral sclerosis","volume":"20","author":"Verschueren","year":"2019","journal-title":"Amyotroph Lateral Scler Frontotemporal Degener."},{"key":"B37","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.jns.2009.08.016","article-title":"Suicide and suicidal ideation in Parkinson's disease","volume":"289","author":"Kostic","year":"2010","journal-title":"J Neurol Sci."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1002\/mds.22130","article-title":"Suicidal and death ideation in Parkinson's disease","volume":"23","author":"Nazem","year":"2008","journal-title":"Mov Disord"},{"key":"B39","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/NMD.0b013e31825322cf","article-title":"Prevalence of suicidal ideation and related risk factors in the German general population","volume":"200","author":"Forkmann","year":"2012","journal-title":"J Nerv Ment Dis."},{"key":"B40","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1001\/jama.2019.21834","article-title":"Association between neurological disorders and death by suicide in Denmark","volume":"323","author":"Erlangsen","year":"2020","journal-title":"JAMA."},{"key":"B41","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1097\/WAD.0000000000000299","article-title":"Differences in awareness of disease between young-onset and late-onset dementia","volume":"33","author":"Baptista","year":"2019","journal-title":"Alzheimer Dis Assoc Disord."},{"key":"B42","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1097\/WAD.0b013e31826cffa5","article-title":"Awareness and its association with affective symptoms in young-onset and late-onset Alzheimer disease: a prospective study","volume":"27","author":"van Vliet","year":"2013","journal-title":"Alzheimer Dis Assoc Disord."},{"key":"B43","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1136\/medethics-2017-104644","article-title":"Advance euthanasia directives: a controversial case and its ethical implications","volume":"45","author":"Miller","year":"2019","journal-title":"J Med Ethics."},{"key":"B44","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1136\/medethics-2018-104951","article-title":"Dementia and advance directives: some empirical and normative concerns","volume":"45","author":"Jongsma","year":"2019","journal-title":"J Med Ethics."},{"key":"B45","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1136\/medethics-2018-105031","article-title":"Response to: \u2018dementia and advance directives: some empirical and normative concerns\u2019 by Jongsma et al","volume":"45","author":"Kim","year":"2019","journal-title":"J Med Ethics."},{"key":"B46","unstructured":"2019"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.647396\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T08:57:06Z","timestamp":1627376226000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.647396\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,27]]},"references-count":46,"alternative-id":["10.3389\/fneur.2021.647396"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.647396","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,27]]},"article-number":"647396"}}