The role of dementia and mild cognitive impairment in deaths by suicide in Australia: A retrospective study of coronial records.

OBJECTIVE

To characterise the cohort of individuals who died by suicide in two Australian states where dementia or mild cognitive impairment was implicated in the death, and to examine the themes related to their deaths.

DESIGN

Retrospective multi-methods study.

SETTING

Coronial data, including police and autopsy reports, held in the National Coronial Information System.

PARTICIPANTS

All individuals who died by suicide in South Australia and New South Wales between 2011 and 2020 where dementia or mild cognitive impairment was relevant to their death (n = 152).

MEASUREMENTS: Descriptive quantitative analysis of demographic and clinical data, and thematic analysis of themes in autopsy and police reports.

RESULTS

Included deaths were 67 people with confirmed dementia or MCI, 24 people with suspected dementia or MCI, 56 family members/friends of people with dementia or MCI, and 5 people who cited fear of dementia as a contributing factor for their death. The cohort were majority male (62.4 %), aged 74 years on average at the time of death (standard deviation 12.5 years), married (53.9 %), and retired (74.3 %). Themes described psychological distress and existential despair related to impairments, loss of autonomy and burdensomeness, fear of future degeneration and burdening others even where dementia onset had not occurred, factors external to but related to the dementia that cause distress and burden for family members and friends (e.g. housing, legal matters), and the phenomenon of simultaneous deaths.

CONCLUSIONS

Mitigation of secondary effects of dementia, as well as fear and stigma, may prevent some death by suicide.