Associated factors of suicidal ideation among older persons with dementia living at home in eight European countries.

ABSTRACT
Objectives: This study aimed to investigate the occurrence of suicidal ideation and associated
factors in older persons with dementia living at home in eight European countries, and its association with quality of life. Furthermore, changes in suicidal ideation over time were investigated.
Methods: This cohort study (n ¼ 1,223) was part of the European “RightTimePlaceCare” project
conducted in 2010–2013. Participating countries were Estonia, Finland, France, Germany, the
Netherlands, Spain, Sweden and the United Kingdom. Baseline and follow-up data were analysed
using bivariate and multivariate logistic regression.
Results: The occurrence of suicidal ideation in the participating countries varied between 6% and
24%. Factors significantly (p < 0.0018) associated with suicidal ideation using bivariate analysis
were: nationality, depressive symptoms, delusions, hallucinations, agitation, anxiety, apathy, disinhibition, irritability, night-time behaviour disturbances, anxiolytics and anti-dementia medication. In
the multivariate regression analysis, country of origin, moderate stage of the dementia, depressive
and delusional symptoms, and anti-dementia medication were significantly associated with suicidal
ideation (p < 0.05). Over time, suicidal ideation decreased from severe to mild or became absent in
54% of the persons with dementia.
Conclusion: It is essential that professionals identify older persons with dementia and suicidal
ideation and depressive and other psychological symptoms in order to give them appropriate
treatment and provide relief for their informal caregivers. We emphasize the importance of identifying suicidal ideation, irrespective of depressive symptoms, and specifically of paying attention to
persons with moderate dementia. Living with the informal caregiver seems to be associated with
staying stable without suicidal ideation.