Objective: The goal of this study was to identify the prevalence of suicidal ideation (SI) in Lewy body dementia (LBD) and the factors associated with SI in this population utilizing a database from a single-center movement disorders clinic.

Background:
 ​​​Neuropsychiatric disturbance is common in individuals with LBD [1] and is associated with increased risk of suicidality in older adults and individuals with Parkinson disease. SI has previously been reported in <2% of individuals with LBD [2]. In a 2017 survey, nearly 1% of deaths were attributed to suicide in individuals with dementia with Lewy bodies [3]. In 2020, the Lewy Body Dementia Association recognized the paucity of research regarding SI in individuals with LBD and called for this need to be met [4].

Method: This study was a retrospective review of a prospectively-collected database at a tertiary movement disorders clinic. Database participants were included if they had a diagnosis of LBD at the most recent clinic visit and at least one completed Beck Depression Inventory-II (BDI-II). The presence of SI was determined using BDI-II question 9. Other measures included age, gender, level of education, disease duration, Unified Parkinson Disease Rating Scale, Beck Anxiety Inventory, and Parkinson Disease Questionaire-39. Logistic regression assessed variables associated with SI.

Results: Ninety-five database participants met inclusion criteria of LBD diagnosis and at least one completed BDI-II between 2010 and 2020. The majority of these participants were older men self-identifying as white. Eighteen individuals with LBD (18.9%; 95%CI 12.3%-28.0%) reported thoughts of killing themselves without intent to follow through (BDI-II question 9=1). No patients reported desire or plan to kill themselves (BDI-II question 9=2 or 3, respectively). Depression, anxiety, and emotional distress were associated with SI when adjusted for age and gender. Measures of disease severity and other cognitive and psychiatric concerns were not associated with SI.

Conclusion: The prevalence of SI in this study of individuals with LBD is higher than previously reported [2]. This emphasizes the importance of screening for and treatment of psychiatric symptoms in this population. Additional research should assess SI and risks for SI in additional LBD cohorts. Future studies are needed to optimize strategies to screen for and appropriately address SI in LBD.

References: 1. Walker Z, Possin KL, Boeve BF, Aarsland D. Lewy body dementias. Lancet. 2015;386:1683-1697. 2. A.X. Lai, A.R. Kaup, K. Yaffe, A.L. Byers, High Occurrence of Psychiatric Disorders and Suicidal Behavior Across Dementia Subtypes, Am J Geriatr Psychiatry 26(12) (2018) 1191-1201. 3. M.J. Armstrong, S. Alliance, P. Corsentino, S.T. DeKosky, A. Taylor, Cause of death and end-of-life experiences in dementia with Lewy bodies, J Am Geriatr Soc 67(1) (2019) 67-73. 4. M.J. Armstrong, J.L. Sullivan, K. Amodeo, A. Lunde, D.W. Tsuang, M.A. Reger, Y. Conwell, A. Ritter, J. Bang, C.U. Onyike, Z. Mari, P. Corsentino, A. Taylor, Suicide and Lewy body dementia: Report of a Lewy body dementia association working group, Int J Geriatr Psychiatry (2020).

« Back to MDS Virtual Congress 2021

MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-of-suicidal-ideation-and-associated-clinical-features-in-lewy-body-dementia/