Robin Williams’ widow’s claim that it was a form of dementia, and not depression, that caused her husband to hang himself turns the spotlight on the link between dementia and suicide, a top doctor says.
“Dementia can lead to depression, which increases the risk of suicide. But even aside from that, if you have dementia, and you have the cognitive awareness to know what the future might hold, this could very well lead some people to commit suicide as well,” says Dr. Gary Small, a professor and director of the University of California-Los Angeles Longevity Center.
In interviews this week, Susan Williams broke her silence about her husband’s death in 2014, saying that the actor had not only been diagnosed with Parkinson’s disease a few months before his death, but also that the coroner’s report found signs of Diffuse Lewy Body Dementia.
"It was not depression that killed Robin. Depression was one of let's call it 50 symptoms and it was a small one,” said Williams, maintaining that it was the disordered thinking stemming from Lewy body dementia that had played the major role in her husband’s decision to take his own life.
About 1.4 million Americans have Lewy body dementia, which is the second most common progressive neurodegenerative disorder after Alzheimer’s disease. The disease, which is frequently misdiagnosed, causes fluctuations in mental status, hallucinations, and impairment of motor function, as well as anxiety and depression.
Although Dr. Small said he is unaware of any link between Lewy body dementia and suicide, the connection between dementia in general and depression is well documented and “depression, of course, increases the risk of suicide,” he noted.
But beyond depression, there is the concern that people who have dementia, and still retain cognitive awareness, could become suicidal because of their fear of losing their cognitive abilities, says Dr. Small, who is author of The Mind Health Report
At the time of Williams’ death, his wife said he was dealing with early stage Parkinson’s disease.
Claims that Lewy Body dementia had contributed to Williams’ death were made last year, but medical experts said then it was impossible to determine whether the disease was a factor, especially in light of the actor’s history of clinical depression.
Although the link between suicide and dementia is a controversial one, there is some evidence that receiving a diagnosis of dementia could increase the risk of a person committing suicide, especially if they are cognitively aware of what the future might hold in store for them.
Researchers who studied 294,952 men aged 60 and older who were diagnosed with depression between 2001 and 2005. Among those patients, 241 (0.09 percent) committed suicide during the study period.
The majority of suicides (75 percent) occurred in those patients with a new dementia diagnosis, a finding that seemed to confirm the conventional wisdom that people with dementia are most at risk of suicide during the early course of the illness.
The method used in the vast majority of suicides was a firearm (72.6 percent); self-poisoning and hanging were the next most common methods, at 9.5 percent each, according to the study, which was published in Alzheimer’s & Dementia.
Such findings are logical because it is in the early stages of dementia that people would be cognitively aware of not only what is happening to them but might also fear an eventual downward slide, Dr. Small says.
“Apart from feeling depressed, a person in that situation still has the cognitive ability to realize what could be coming and the ability to act on those feelings, so a medical health practitioner so anyone expressing those concerns has to be taken seriously and evaluated,” Dr. Small notes.
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