Elderly Offenders With Suspected Neurocognitive Disorders: An Explorative Study

Background: Life expectancy is increasing globally. A substantial expected rise in older age groups in the population is reflected in prisons, but focus on elderly offenders remains limited compared to other age groups. This is of concern, as cognitive impairments are often present among elderly offenders, possibly affecting their behaviour, criminal responsibility and responsiveness to treatment. Aims: The objective of this study was to explore the associations between various cognitive variables, neurological diagnosis and different types of crime by offenders of 60 years or older. Methods: In this retrospective records-based clinical study, we used the reports about adult defendants who underwent a full forensic psychiatric evaluation at the request of the court to assess criminal responsibility for serious crime. Individuals aged 60 and over were included, resulting in a sample of 81 persons, just seven of them women. A homogeneity analysis (HOMALS) was conducted to examine the possibility of classifying such people according to cognitive and offence status. Results: Nearly two-thirds of these people under criminal charges had some evidence of cognitive impairment. Three main neurocognitive groups were apparent: those with clear cognitive deficiencies, and usually a clinical diagnosis of dementia, those with some cognitive impairment and those with equivocal or not cognitive impairment. The first group was older and most likely to have violence charge(s), the second to be characterised by both violent and sexual charge(s) and the third more various offending, albeit including violence. Conclusions: This first study of detailed neurocognitive assessment of older people under trial for a serious criminal offence indicates that it is important for older people charged with offences to have sound cognitive assessment, in their interests, and for planning effective management of risk of any further offending. Future studies should investigate relationships between cognitive problems and type of crime in a larger and perhaps more varied group.