Suicidality among people with mild cognitive impairment: a sustematic review

Abstract

Background: Mild cognitive impairment (MCI) is a clinical stage between the expected cognitive decline of healthy ageing and dementia. People with MCI experience functional decline, social isolation and emotional symptoms that may increase suicidal thoughts and behaviours (STB). We aimed to explore the relationship between MCI and STB, as well as clinical and socioeconomic factors that may contribute to it.

Methods: To achieve our aims we carried out a comprensive systematic review of the existing scientific literature. We searched the following electronic databases up to June 2024: PubMed, Scopus, Cochrane Library, Web Of Science (WOS) and EMBASE. We employed the Cochrane Risk of Bias In Non-randomized Studies - of Exposure (ROBINS-E) and the Newcastle-Ottawa Scale to assess the quality of the eligible studies.

Results: An initial search retrieved 1,176 publications; however, only 11 studies met eligibility criteria to be included in the final analysis. The quality of these studies ranged from 3 to 8 out of a maximum score of 9 in the Newcastle-Ottawa Scale, with a median score of 6. People with a formal diagnosis of MCI showed a higher prevalence of STB than those without such condition or with a more severe cognitive impairment. Comorbid psychiatric disorders, such as depression, other health problems, such as cardiovascular diseases, and a low socioeconomic status and/or poor educational background seemed to contribute to suicide risk in people with MCI.

Conclusion: Our systematic review suggests that people suffering MCI may be at an increased risk of presenting STB. Suicide prevention programmes for older populations with MCI should advocate for integrated health and social care models to tackle the clinical and social burden of suffering MCI.

Keywords: MCI; Mild cognitive impairment; Mortality; Suicide.; Systematic review.

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Flow diagram

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Risk of bias