Dementia and self-harm: why it's crucial to support patients in first year after diagnosis

Researchers uncover evidence in hospital data showing link between dementia and self-harm.

People diagnosed with dementia are more likely to self-harm within the first six to 12 months after initial diagnosis, highlighting the need for health services to offer more follow-up support in this crucial period.

In what is believed to be the largest study of its kind, researchers with expertise in medicine, psychiatry and psychology at UNSW Sydney looked at NSW hospital data captured for more than 180,000 people admitted to hospital between 2001 and 2015.

The researchers analysed statistics relating to two cohorts of patients admitted to hospital: 154,811 people recorded as having dementia, and 28,972 people admitted for self-harm injuries.

UNSW Medicine & Health’s Dr Adrian Walker, who was the study lead author, says while smaller studies and anecdotal evidence had previously suggested a link between dementia diagnoses and self-harm, the NSW hospital data supports the findings in a large population setting.

“We were interested in finding people who came to those health services and had been diagnosed with dementia to see if we could find out, what are the rates and predictors of self-harm among people living with dementia?” Dr Walker says.

“We know that that’s an important question because dementia itself is associated with not only a lot of neurological changes, but also a lot of grief and a lot of anxiety. And it can create this perfect storm of factors that may contribute to self-harm.”

When the researchers examined the data, they saw that of the people recorded as having dementia by health services (hospitals and outpatient facilities), 692 of them went on to be readmitted to hospital for self-harm.

Women accounted for the majority of both people initially admitted to hospital with dementia (60 per cent) and initially admitted because of self-harm (53 per cent). But when researchers looked at the number of people who went on to self-harm after being admitted initially with dementia, the ratios between the sexes flipped, with men making up 60 per cent of those admissions.

“Generally, women tend to be over-represented in people diagnosed with dementia, as well as people who self-harm, compared to men,” says Dr Walker.

“The fact that there are more men at the intersection of self-harm and dementia is concerning, though we should also be careful not to forget the substantial number of women living with dementia who self-harm.”

And when the researchers drilled down further into those numbers, the episodes of self-harm for both men and women appeared alarmingly soon, within 12 months of the first hospital visit for dementia.

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