Investigation of Alzheimer's disease-related pathology in community dwelling older subjects who committed suicide
ABSTRACT Older people have a higher risk of completed suicide than any other age group worldwide. The contribution of neurodegenerative disease to this risk remains controversial.
To investigate prevalence of Alzheimer's disease-related (AD) pathology in older suicide victims.
Ratings of AD pathology using Braak and CERAD protocols were compared in 143 community-dwelling suicide victims aged 65 years or more and 59 motor vehicle accident victims autopsied at the request of an Australian Coroner's Court.
There were no significant differences in plaque score or neurofibrillary tangle staging between suicide and control groups. None of the subjects with a history of dementia had neuropathologically confirmed AD.
Our study is the second and largest investigation of the prevalence of AD neuropathology in the elderly suicide population. Unlike the previous study, we did not find an increased prevalence of AD neuropathology despite a history of dementia in 6.3%, implicating other pathologies such as Lewy Body or Vascular dementia in the aetiology of dementia in elderly suicide victims.
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ABSTRACT: Allgemeine Modelle zur Entstehung suizidalen Verhaltens können die überproportionale Betroffenheit alter Menschen nur unzureichend erklären. Das hier vorgestellte transaktionale Modell versucht, die komplexen Bedingungen suizidaler Handlungen im Alter darzustellen. Diskutiert wird eine vielfache reziproke Abhängigkeit von biologischen, psychologischen und sozialen Faktoren, die suizidales Verhalten i.S. eines Problemlöseverhaltens erleichtern können. General theories of suicidology are insufficient to explain the overproportional rate of suicidal behaviour in the elderly. The proposed transactional model represents a bio-psycho-social foundation of suicidal behavior in the elderly. The reciprocal interactions of biological, somatic, psychological and social factors in old age which may enhance suicidal behavior as a mode of problem-solving behavior are discussed.Zeitschrift für Gerontologie + Geriatrie 02/2008; 41(1):14-21. DOI:10.1007/s00391-008-0518-y · 1.02 Impact Factor
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ABSTRACT: General theories of suicidology are insufficient to explain the overproportional rate of suicidal behaviour in the elderly. The proposed transactional model represents a bio-psycho-social foundation of suicidal behavior in the elderly. The reciprocal interactions of biological, somatic, psychological and social factors in old age which may enhance suicidal behavior as a mode of problem-solving behavior are discussed.Zeitschrift für Gerontologie + Geriatrie 03/2008; 41(1):14-21. · 1.02 Impact Factor
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ABSTRACT: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. Event-history analysis using time-varying covariates. Population-based record linkage. All individuals aged 50+ living in Denmark (N=2,474,767) during January 1, 1990 through December 31, 2000. Outcome of interest is suicide. Relative risks are calculated based on person-days spent in each stratum. A total of 18,648,875 person-years were observed during the 11-year study period. During this period, 136 persons who previously had been diagnosed with dementia died by suicide. Men and women aged 50-69 years with hospital presentations of dementia have a relative suicide risk of 8.5 (95% confidence interval: 6.3-11.3) and 10.8 (95% confidence interval: 7.4-15.7), respectively. Those who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men and 14% of the women who died by suicide died within the first 3 months after being diagnosed whereas 38% of the men and 41% of the women died more than 3 years after initial dementia diagnosis. Dementia, determined during hospitalization, was associated with an elevated risk of suicide for older adults. Preventive measures should focus on suicidal ideation after initial diagnosis but also acknowledge that suicides can occur well after a dementia diagnosis has been established.American Journal of Geriatric Psychiatry 04/2008; 16(3):220-8. DOI:10.1097/JGP.0b013e3181602a12 · 3.52 Impact Factor