Objectives To investigate factors associated with suicidal ideation around the time of dementia diagnosis. We hypothesised that relatively preserved cognition, co-occurring physical and psychiatric disorders, functional impairments and dementia diagnosis subtype would be associated with higher risk of suicidal ideation. Design Cross-sectional study using routinely collected electronic mental healthcare records. Setting National Health Service secondary mental healthcare services in South London, United Kingdom, which serve a population of over 1.36 million residents. Participants Patients who received a diagnosis of dementia (Alzheimer's, vascular, mixed Alzheimer's/vascular or dementia with Lewy bodies) between 1/1/2007-30/6/2016. 11,787 people with dementia were identified during the observation period. Measurements A natural language processing algorithm was used to identify recorded clinician statements about suicidal ideation around the time of dementia diagnosis. Sociodemographic and clinical characteristics were also measured around the time of diagnosis. We compared people diagnosed with non-Alzheimer's dementia to those with Alzheimer's and used statistical models to adjust for putative confounders. Results 4.8% of patients identified with dementia had recorded suicidal ideation. Recorded suicidal ideation was almost twice as common in dementia with Lewy bodies compared to other dementia diagnoses studied. After adjusting for sociodemographic and clinical factors, dementia with Lewy bodies, physical illnesses or disability and neuropsychiatric symptoms were significantly associated with suicidal ideation. Mini-Mental State Examination score at diagnosis was not associated with suicidal ideation. Conclusions Although completed suicide is rare, suicidal ideation is present in sufficient proportions of people with dementia to justify treatment of potentially modifiable risk factors within dementia care pathways.

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痴呆症的自杀意念：与神经精神症状和亚型诊断的关联

目的 调查与痴呆诊断前后自杀意念相关的因素。我们假设相对保留的认知、同时发生的身体和精神疾病、功能障碍和痴呆诊断亚型与更高的自杀意念风险相关。使用常规收集的电子心理健康记录设计横断面研究。在英国伦敦南部设置国家卫生服务二级精神保健服务，为超过 136 万居民提供服务。参与者 在 2007 年 1 月 1 日至 2016 年 6 月 3 日之间被诊断为痴呆症（阿尔茨海默病、血管性、混合性阿尔茨海默病/血管性痴呆或路易体痴呆）的患者。观察期间共识别出 11,787 名痴呆症患者。测量 使用自然语言处理算法来识别记录的临床医生关于痴呆症诊断期间自杀意念的陈述。还在诊断时测量了社会人口学和临床特征。我们将诊断出患有非阿尔茨海默氏症的人与患有阿尔茨海默氏症的人进行了比较，并使用统计模型来调整假定的混杂因素。结果 4.8% 的痴呆症患者记录了自杀意念。与所研究的其他痴呆症诊断相比，路易体痴呆症患者记录的自杀意念几乎是其两倍。在调整社会人口统计学和临床​​因素后，路易体痴呆、身体疾病或残疾以及神经精神症状与自杀意念显着相关。诊断时的简易精神状态检查分数与自杀意念无关。结论 尽管完全自杀是罕见的，但有足够比例的痴呆症患者存在自杀意念，足以证明在痴呆症护理途径中治疗潜在的可改变风险因素是合理的。