To investigate factors associated with suicidal ideation (SI) around the time of dementia diagnosis. We hypothesised relatively preserved cognition, co-occurring physical and psychiatric disorders, functional impairments, and dementia diagnosis subtype would be associated with a higher risk of SI.

Cross-sectional study using routinely collected electronic mental healthcare records.

National Health Service secondary mental healthcare services in South London, UK, serving a population of over 1.36 million residents.

Patients who received a diagnosis of dementia (Alzheimer’s, vascular, mixed Alzheimer’s/vascular, or dementia with Lewy bodies) between 1 Nov 2007–31 Oct 2021: 18,252 people were identified during the observation period.

A natural language processing algorithm was used to identify recorded clinician recording of SI 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.

15.1% of patients had recorded SI, which was more common in dementia with Lewy bodies compared to other dementia diagnoses studied. After adjusting for sociodemographic and clinical factors, SI was more frequent in those with depression and dementia with Lewy bodies and less common in those with impaired activities of daily living and in vascular dementia. Agitated behavior and hallucinations were not associated with SI in the final model.

Our findings highlight the importance of identifying and treating depressive symptoms in people with dementia and the need for further research into under-researched dementia subtypes.

调查痴呆症诊断前后与自杀意念 (SI) 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较高的 SI 风险相关。

使用常规收集的电子精神保健记录进行横断面研究。

位于英国伦敦南部的国民健康服务二级心理保健服务，为超过 136 万居民提供服务。

2007年11月1日至2021年10月31日期间被诊断为痴呆症（阿尔茨海默氏症、血管性痴呆、混合性阿尔茨海默氏症/血管性痴呆或路易体痴呆）的患者：观察期间共识别出18,252人。

使用自然语言处理算法来识别临床医生在痴呆症诊断期间记录的 SI。诊断前后还测量了社会人口学和临床特征。我们将被诊断为非阿尔茨海默氏痴呆症的人与阿尔茨海默氏症患者进行了比较，并使用统计模型来调整假定的混杂因素。

15.1% 的患者记录了 SI，与所研究的其他痴呆症诊断相比，这在路易体痴呆症中更为常见。调整社会人口统计学和临床​​因素后，SI 在抑郁症和路易体痴呆患者中更为常见，而在日常生活活动受损和血管性痴呆患者中则较少见。在最终模型中，激动行为和幻觉与 SI 无关。

我们的研究结果强调了识别和治疗痴呆症患者抑郁症状的重要性，以及对研究不足的痴呆亚型进行进一步研究的必要性。