Title : Risk factors for suicide-attempt-related hospitalizations among people with dementia in Taiwan: A longitudinal population-based cohort study
Abstract:
Although suicide attempts are recognized as significant risk factors for both suicide and dementia, there is limited information on the factors contributing to suicide attempts among dementia patients using nationwide longitudinal data from Asia. This study aims to identify the sociodemographic and clinical factors influencing suicide attempts among dementia patients in Taiwan over a 7-year period, accounting for death as a competing risk, in a population-based setting. We identified a cohort of 266,590 patients aged ?40 years who were newly diagnosed with dementia from the Taiwan National Health Insurance Research Database (2009–2014). These patients were followed until their first hospitalization for a suicide attempt, death, or the end of 2015. Factors influencing the risk of new-onset hospitalization for suicide attempts were analyzed using cause-specific hazard models. Overall, the incidence density (ID) of hospitalizations due to suicide attempts was 1.81 per 1,000 person-years (95% CI: 1.72–1.90), with the highest ID observed within the first year after an initial dementia diagnosis. Male sex, older age, lower salary-based insurance premiums, an initial dementia diagnosis in winter, major depressive disorder, bipolar disorder, other mental health conditions, higher Charlson Comorbidity Index scores, and more frequent outpatient visits were significantly associated with an elevated risk of hospitalization for suicide attempts. In conclusion, dementia patients face a heightened risk of hospitalization for suicide attempts, with the influence of associated factors varying by sociodemographic and clinical characteristics. Public health interventions should consider these differences to more effectively prevent suicide attempts in this population.
