Differences in the Prevalence and Risk Factors of Suicidal Behavior Between Cargivers and People with Dementia: A Systematic Review

Abstract

AbstractBackground:Caregivers of dementia patients and people with dementia are prone to exhibit suicidal behaviors due to difficulty to adjust to the initial caregiving role and emotional disturbance resulting from deterioration of functioning, respectively. This systematic review: [1] explored the prevalence and risk factors of suicidal behavior, and [2] assessed the differences in the prevalence and risk factors of suicidal behavior between caregivers of dementia patients and people with dementia.Methods:A comprehensive literature search for research articles was carried out from 1950 to December 2022 using major databases, such as Google Scholar, Web of Science, PubMed, Scopus, PsycINFO, EMBASE, Cochrane Library, and Medline.Results:A total of 38 research articles were selected for review. A total of 12 research articles revealed that the prevalence of suicidal behavior among caregivers ranged from 4.7% to 26%. However, the risk of suicidal behavior among people with dementia was inconsistent as only 15 out of 26 selected studies reported risk of suicidal behavior among people with dementia. The risk factors associated with suicidal behavior among caregivers of dementia patients could be both self-related and care receiver-related factors, whereas risk factors in dementia patients are self-related factors. Moreover, caregivers with high resilience may bounce back to maintain their initial psychological functioning prior to caregiving and safeguard their mental well-being. Contrastingly, resilience among people with dementia was not reported, but greater cognitive decline which impaired their ability to carry out complex act and planning may lower their suicidal risk. Finally, assessment of risk of bias indicated that 95% of the selected studies had unclear risk.Conclusion:Psychosocial interventions which are effective to enhance resilience should be provided to caregivers in the management of psychological impact of the caregiving role for dementia patients. In addition, we recommend evaluation of suicidal risk on dementia patients to be carried out in the early phase of dementia when cognitive decline is less severe. However, as majority of selected studies had unclear risk of bias, future studies with improve methodology are warranted to confirm our study findings.