Alzheimer's & Dementia: The Journal of the Alzheimer's Association
Volume 6, Issue 1 , Pages 75-82 , January 2010

Early dementia diagnosis and the risk of suicide and euthanasia

  • Brian Draper

      Affiliations

    • School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
    • Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
    • Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
    • Corresponding Author InformationCorresponding author. Tel.: 61-2-93823759; Fax: 61-2-93823762.
    • ,
  • Carmelle Peisah

      Affiliations

    • School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
    • Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
    • ,
  • John Snowdon

      Affiliations

    • Discipline of Psychological Medicine, University of Sydney, Sydney, New South Wales, Australia
    • Sydney South West Area Health Service, Sydney, New South Wales, Australia
    • ,
  • Henry Brodaty

      Affiliations

    • School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
    • Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
    • Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia

References 

  1. Foy R, Francis JJ, Johnston M, Eccles M, Lecouturier J, Bamford C, et al. The development of a theory-based intervention to promote appropriate disclosure of a diagnosis of dementia. BMC Health Serv Res. 2007;19:207
  2. Carpenter BD, Xiong C, Porensky EK, Lee MM, Brown PJ, Coats M, et al. Reaction to a dementia diagnosis in individuals with Alzheimer's disease and mild cognitive impairment. J Am Geriatr Soc. 2008;56:405–412
  3. Valcour VG, Masaki KH, Curb JD, Blanchette PL. The detection of dementia in the primary care setting. Arch Intern Med. 2000;160:2964–2968
  4. Bond J, Stave C, Sganga A, O'Connell B, Stanley RL. Inequalities in dementia care across Europe: key findings of the Facing Dementia Survey. Int J Clin Pract. 2005;59:s146
  5. Luscombe G, Brodaty H, Freeth S. Younger people with dementia: diagnostic issues, effects on carers and use of services. Int J Geriatr Psychiatry. 1998;13:323–330
  6. Petersen R. Mild cognitive impairment: current research and clinical implications. Semin Neurol. 2007;27:22–31
  7. Bertram L, McQueen MB, Mullin K, Blacker D, Tanzi RE. Systematic meta-analyses of Alzheimer disease genetic association studies: the AlzGene database. Nat Genet. 2007;39:17–23
  8. Brodaty H, Conneally M, Gauthier S, Jennings C, Lennox A, Lovestone S. Medical and Scientific Advisory Committee, Alzheimer's Disease International, consensus statement on predictive testing for Alzheimer's disease. Alzheimer Dis Assoc Disord. 1995;9:182–187
  9. Dubois B, Feldman HH, Jacova C, DeKosky ST, Barberger-Gateau P, Cummings J, et al. Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurol. 2007;6:734–746
  10. Blenow K, Hampel H. CSF markers for incipient Alzheimer's disease. Lancet Neurol. 2003;2:605–613
  11. Rowe CC, Ackerman U, Browne W, Mulligan R, Pike KL, O'Keefe G, et al. Imaging of amyloid beta in Alzheimer's disease with 18F-BAY94-9172, a novel PET tracer: proof of mechanism. Lancet Neurol. 2008;7:129–135
  12. Suhr JA, Kinkela JH. Perceived threat of Alzheimer disease (AD): the role of personal experience with AD. Alzheimer Dis Assoc Disord. 2007;21:225–231
  13. Hertogh CMPM. End-of-life care and medical decision making in patients with dementia. In:  Burns A editors. Standards in Dementia Care—European Dementia Consensus Network (EDCON). New York: Taylor & Francis; 2005;p. 339–354
  14. Hertogh CM, de Boer ME, Dröes RM, Eefsting JA. Would we rather lose our life than lose our self? Lessons from the Dutch debate on euthanasia for patients with dementia. Am J Bioeth. 2007;7:48–56
  15. Cooley DR. A Kantian moral duty for the soon-to-be-demented to commit suicide. Am J Bioeth. 2007;7:37–44
  16. Aminzadeh F, Byszewski A, Molnar FJ, Eisner M. Emotional impact of dementia diagnosis: exploring persons with dementia and caregivers' perspectives. Aging Ment Health. 2007;11:281–290
  17. Erlangsen A, Zarit SH, Conwell Y. Hospital-diagnosed dementia and suicide: a longitudinal study using prospective, nationwide register data. Am J Geriatr Psychiatry. 2008;16:220–228
  18. Rabins PV. Can suicide be a rational and ethical act in persons with early or pre-dementia?. Am J Bioeth. 2007;7:47–49
  19. De Boer ME, Hertogh CMPM, Droes R, Riphagen , Jonker C, Eefsting JA. Suffering from dementia—the patient's perspective: a review of the literature. Int Psychogeriatr. 2007;19:1021–1039
  20. Cahill S, Begley E, Topo P, Saarikalle K, Macijauskiene J, Budraitiene A, et al. I know where this is going and I know it won't go back. Dementia. 2004;3:313–330
  21. Edelman P, Fulton BR, Kuhn D, Chang C. A comparison of three methods of measuring dementia-specific quality of life: perspectives of residents, staff and observers. Gerontologist. 2005;45:27–36
  22. Post SG. Physician-assisted suicide in Alzheimer's disease. J Am Geriatr Soc. 1997;45:647–651
  23. Steinberg M, Shao H, Zandi P, Lyketsos CG, Welsh-Bohmer KA, Norton MC, et al. Point and 5-year period prevalence of neuropsychiatric symptoms in dementia: the Cache County Study. Int J Geriatr Psychiatry. 2008;23:170–177
  24. Davis JK. The concept of precedent autonomy. Bioethics. 2002;16:114–133
  25. Gedge EB. Collective moral imagination: making decisions for person with dementia. J Med Philos. 2004;29:435–450
  26. Degrazia D. Advance directives, dementia, and the “someone else problem”. Bioethics. 1999;13:373–375
  27. Burkhardt S, La Harpe R, Harding TW, Sobel J. Euthanasia and assisted suicide: comparison of legal aspects in Switzerland and other countries. Med Sci Law. 2006;46:287–294
  28. Hertogh CMPM. The role of advance euthanasia directives as an aid to communication and shared decision-making in dementia. J Med Ethics. 2009;35:100–103
  29. Ganzini L, Leong GB, Fenn DS, Silva JA, Weinstock R. Evaluation of competence to consent to assisted suicide. Am J Psychiatry. 2000;157:595–600
  30. Kelly MJ, Mufson MJ, Rogers MP. Medical settings and suicide. In:  Jacobs DG editors. The Harvard Medical School Guide to Suicide Assessment and Intervention. San Francisco: Jossey-Bass; 1999;p. 491–519
  31. Chochinov HM, Wilson KG, Enns M, Mowchun N, Lander S, Levitt M, et al. Desire for death in the terminally ill. Am J Psychiatry. 1995;152:1185–1191
  32. Clarke DM. Autonomy, rationality and the wish to die. J Med Ethics. 1999;25:457–462
  33. Snowdon J, Baume P. A study of suicides of older people in Sydney. Int J Geriatr Psychiatry. 2002;17:261–269
  34. Lerner BH. A calculated departure. Washington Post. March 2, 2004;
  35. Battin MP. The concept of rational suicide. In:  Shneidman ES editors. Death: Current Perspectives. Palo Alto, CA: Mayfield Publishing; 1984;p. 297–320
  36. Maris R. Rational suicide: an impoverished self-transformation. Suicide Life Threat Behav. 1982;12:4–16
  37. Prado CG. The Last Choice: Preemptive Suicide in Advanced Age. Greenwich, CT: Greenwood; 1998;
  38. Werth JL, Cobia DC. Empirically based criteria for rational suicide: a survey of psychotherapists. Suicide Life Threat Behav. 1995;25:231–240
  39. Conwell Y, Duberstein PR, Caine ED. Risk factors for suicide in later life. Biol Psychiatry. 2002;52:193–204
  40. Chan J, Draper B, Banerjee S. Deliberate self-harm in older adults: a review of the literature from 1995 to 2004. Int J Geriatr Psychiatry. 2007;22:720–732
  41. Harris EC, Barraclough B. Suicide as an outcome for mental disorders. Br J Psychol. 1997;170:205–228
  42. Margo GM, Finkel JA. Early dementia as a risk factor for suicide. Hosp Community Psychiatry. 1990;41:676–678
  43. Lim WS, Rubin EH, Coats M, Morris JC. Early-stage Alzheimer disease represents increased suicidal risk in relation to later stages. Alzheimer Dis Assoc Disord. 2005;19:214–219
  44. Barak Y, Aizenberg D. Suicide amongst Alzheimer's disease patients: a 10-year survey. Dement Geriatr Cogn Disord. 2002;14:101–103
  45. Draper B. Attempted suicide in old age. Int J Geriatr Psychiatry. 1996;11:577–587
  46. Carney SS, Rich CL, Burke PA, Fowler RC. Suicide over 60: the San Diego Study. J Am Geriatr Soc. 1994;42:174–180
  47. Waern M, Rubinowitz E, Wilhelmsson K. Predictors of suicide in the old elderly. Gerontology. 2003;49:328–334
  48. Beautrais AL. A case control study of suicide and attempted suicide in older adults. Suicide Life Threat Behav. 2002;32:1–9
  49. Préville M, Boyer R, Hébert R, Bravo G, Seguin M. Correlates of suicide in the older adult population in Quebec. Suicide Life Threat Behav. 2005;35:91–105
  50. Draper B, Brodaty H, Low L-F, Richards V, Paton H, Lie D. Self destructive behaviours in nursing home residents. J Am Geriatr Soc. 2002;50:354–358
  51. De Jonghe-Rouleau AP, Pot AM, de Jonghe JFM. Self-injurious behaviour in nursing home residents with dementia. Int J Geriatr Psychiatry. 2005;20:651–657
  52. Draper B, Brodaty H, Low L-F, Richards V. Prediction of mortality in nursing home residents: impact of self-destructive behaviours. Int Psychogeriatr. 2003;15:187–196
  53. Rapp MA, Schnaider-Beeri M, Grossman HT, Sano M, Perl DP, Purohit DP, et al. Increased hippocampal plaques and tangles in patients with Alzheimer disease with a lifetime history of major depression. Arch Gen Psychiatry. 2006;63:161–167
  54. Rubio A, Vestner AL, Stewart JM, Forbes NT, Conwell Y, Cox C. Suicide and Alzheimer's pathology in the elderly: a case-control study. Biol Psychiatry. 2001;49:137–145
  55. Hwang JP, Yang CH, Hong CJ, Lirng JF, Yang YM, Tsai SJ. Association of APOE genetic polymorphism with cognitive function and suicide history in geriatric depression. Dement Geriatr Cogn Disord. 2006;22:334–338
  56. Peisah C, Snowdon J, Gorrie C, Kril J, Rodriguez M. Investigation of Alzheimer's disease-related pathology in community dwelling older subjects who committed suicide. J Affect Disord. 2007;99:127–132
  57. Peisah C, Snowdon J, Gorrie C, Kril J, Rodriguez M. Clinicopathological findings of suicide in the elderly: three cases. Suicide Life Threat Behav. 2007;37:648–658
  58. Draper B, MacCuspie-Moore C, Brodaty H. Suicidal ideation and the “wish to die” in dementia—the role of depression. Age Ageing. 1998;27:503–507
  59. Bowirrat A, Oscar-Berman M, Logroscino G. Association of depression with Alzheimer's disease and vascular dementia in an elderly Arab population of Wadi-Ara, Israel. Int J Geriatr Psychiatry. 2006;21:246–251
  60. Hayden MR. Predictive testing for Huntington's disease: a universal model?. Lancet Neurol. 2003;2:141–142
  61. Almqvist EW, Bloch M, Brinkman R, Craufurd D, Hayden MR. A worldwide assessment of the frequency of suicide, suicide attempts, or psychiatric hospitalisation after predictive testing for Huntington's disease. Am J Hum Genet. 1999;64:1293–1304
  62. Robins Wahlin T-B, Bäckman L, Lundin A, Hagermark A, Winblad B, Anvret M. High suicidal ideation in persons testing for Huntington's disease. Acta Neurol Scand. 2000;102:150–161
  63. Robins Wahlin T-B, Lundin A, Dear K. Early cognitive deficits in Swedish gene carriers of Huntington's disease. Neuropsychology. 2007;21:31–44
  64. Carpenter B, Dave J. Disclosing a dementia diagnosis: a review of opinion and practice. Gerontologist. 2004;44:149–158

PII: S1552-5260(09)00104-6

doi: 10.1016/j.jalz.2009.04.1229

Alzheimer's & Dementia: The Journal of the Alzheimer's Association
Volume 6, Issue 1 , Pages 75-82 , January 2010

Article Tools