'Perfect storm' link found between dementia, self-harm

When Stephen Grady was diagnosed with dementia at 60 he wondered if life was worth living any more.

The scientist was one of the leading people in his field.

"And then suddenly after being diagnosed, it felt like I went from a valuable contributor to society to having no value at all,'' he said.

"So, there's this whole question of, 'Okay, is your life over, is it still worth living?'"

He was speaking after the release of research that found dementia patients are more likely to self-harm within the first year of diagnosis.

Adrian Walker, the lead author of a University of NSW study, says the debilitating disease can create a "perfect storm" of factors that may contribute to self-destructive behaviour.

His team of researchers scrutinised data from more than 180,000 people admitted to NSW hospitals between 2001 and 2015, including those with dementia and those admitted for self-harm injuries.

Of the 154,811 people recorded as having dementia, 692 were readmitted to hospital for self-harm within 12 months of the first visit for dementia.

"Dementia itself is associated with not only a lot of neurological changes but also a lot of grief and a lot of anxiety," Dr Walker said. 

"And it can create this perfect storm of factors that may contribute to self-harm."

Researchers also found evidence of a reverse trajectory – people first admitted because of self-harm who then developed dementia.

"Whether self-harm might lead to dementia, or dementia might lead to self-harm, is still an open question," he said.

"Indeed, it could be both and it could also be neither – there could be something else going on. But what is clear in the numbers is that the two are linked." 

Those living with dementia who self-harmed tended to be younger at their initial dementia diagnosis than those with no record of self-harm.

People living with dementia with complex psychiatric profiles also had a higher risk of presenting to hospital for self-harm.

There are more than 400,000 people living in Australia with dementia and that is expected to increase to more than 800,000 by 2058.

It's already the leading cause of death for women and the second leading cause of death of all Australians.

UNSW Associate Professor Simone Reppermund said a lack of availability of reliable data and confusing self-harm with accidents made the data difficult to decipher.

"Self-harm can be a result of the diagnosis because people feel totally helpless and alone. They don't see a purpose in life anymore," she said.

The research findings were published on Tuesday in the journal Alzheimer's and Dementia: The Journal of the Alzheimer's Association.

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