Suicide Risk in Alzheimer's Disease: A Systematic Review

Suicidal behavior is a common cause of death in the elderly and is often accompanied in this population by disabilities and psychosocial impairment. Alzheimer's-related neuropathological changes are commonly found in the brains of older people. Although Alzheimer's disease (AD) has been reported to be a potential predictor for suicidal behavior, the relationship between suicidal behavior and AD has not been systematically explored. The aim of this paper is to review the current literature regarding the association between suicide risk and AD in an effort to identify the most relevant risk and protective factors for suicide. A detailed strategy was used to search for relevant articles in Pubmed, Scopus, PsycINFO, and Science Direct on suicidal behavior and AD for the period of January 1980 to August 2015. The search yielded 164 articles, of which 21 met our inclusion criteria. Eight crosssectional, two longitudinal, 3 retrospective, and eight case reports (of 11 patients) examined the association between suicide risk and AD. Suicide occurs in AD even many years after the diagnosis of dementia, and patients who have attempted suicide once are at a higher risk of dying from suicide. AD is associated with a moderate risk of suicide, and clinicians working with AD patients should undertake an appropriate assessment of their suicidal risk. However, more prospective studies are needed to clarify the association between AD and suicide risk.