title: The survival and characteristics of older people with and without dementia who are hospitalised following intentional self-harm.
abstract: Characteristics of older people with and without dementia who are hospitalised following self-harm remains largely unexplored. This research compares the characteristics of older people with and without dementia who self-harm, compares associations of mental health-related diagnoses with those hospitalised for a self-harm and a non-self-harm injury and examines mortality by injury intent.
  
  
  
  A population-based study of individuals aged 50+ years with and without dementia admitted to hospital for a self-harm injury (and those with other injuries) using linked hospital admission and mortality records during 2003-2012 in New South Wales (NSW), Australia. Health outcomes, including hospital length of stay (LOS), 28-day readmission and 30-day and 12-month mortality were examined by dementia status.
  
  
  
  There were 427 hospitalisations of individuals with dementia and 11,684 hospitalisations of individuals without dementia following self-harm. The hospitalisation rate for self-harm for individuals with dementia aged 60+ years was double the rate for individuals without dementia (72.2 and 37.5 per 100,000). For both older people with and without dementia, those who self-harmed were more likely to have co-existent mental health and alcohol use disorders than individuals who had a non-self-harm injury. Individuals with dementia had higher 12-month mortality rates, 28-day readmission and longer LOS than individuals without dementia.
  
  
  
  Dementia is associated with an increased risk of hospitalisation for self-harm in older people and worse outcomes. The high rate of coexistent mental health conditions suggests that interventions which reduce behavioural and psychological symptoms of dementia might reduce self-harm in people with dementia. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Australian Institute of Health Innovation, Macquarie University, Australia.|Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mitchell
authors.affiliation: Dementia Collaborative Research Centre-Assessment and Better Care, University of New South Wales, Sydney, Australia.|Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: Draper
authors.affiliation: Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Australia.
authors.forename: Lara
authors.initials: L
authors.lastname: Harvey
authors.affiliation: Dementia Collaborative Research Centre-Assessment and Better Care, University of New South Wales, Sydney, Australia.|Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Australia.|Prince of Wales Clinical School, University of New South Wales, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Close
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications* / Q000401:mortality; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000209:etiology* / Q000401:mortality
keywords: dementia; older person; self-harm