Risk of Suicide in Association with Major Depressive Disorder among Patients with Dementia: A Population-based Nested Case-Control Study.

ABSTRACT

OBJECTIVE: This study aimed to explore the association between major depressive disorder (MDD) and suicide risk in dementia patients. METHODS: A cohort of 625,218 individuals aged ≥40 years with dementia between 2007 and 2018 was identified from Taiwan's National Health Insurance Research Database. After excluding prevalent cases in 2007. Subsequently, a nested case-control study enrolled 1,256 suicide cases and 5,022 matched controls was conducted. The frequencies of MDD-related outpatient or inpatient visits over a 7-year period preceding the event dates were calculated and analyzed for association using conditional logistic regression. RESULTS: Dementia comorbid with MDD was associated with increased suicide risk (adjusted odds ratio [AOR] 2.67), particularly in individuals with ≤1.0 MDD episodes per year (AOR 2.85). Similar association was observed only in individuals aged ≥65 years and males, with a pronounced risk of suicide in those ≤1.0 MDD episodes per year (AOR 3.08 for individuals aged ≥65 years; AOR 3.28 for males). Conversely, the risk increase was evident with >1.0 MDD episodes per year in those aged <65 years (AOR 3.04) and females (AOR 2.45). CONCLUSIONS: MDD is associated with suicide risk in dementia patients, with the strength of this association possibly varying by age and gender.