Examining the propensity and nature of criminal risk behaviours in frontotemporal dementia syndromes and Alzheimer's disease

Fiona Kumfor; Grace Wei; Nola Ries; Hayley Bennett; Mirelle D'Mello; Cassandra Kaizik; Olivier Piguet; John R Hodges

doi:10.1002/dad2.12577

Examining the propensity and nature of criminal risk behaviours in frontotemporal dementia syndromes and Alzheimer's disease

Alzheimers Dement (Amst). 2024 Apr 11;16(2):e12577. doi: 10.1002/dad2.12577. eCollection 2024 Apr-Jun.

Authors

Fiona Kumfor^{1

2}, Grace Wei^{1

2}, Nola Ries³, Hayley Bennett⁴, Mirelle D'Mello^{1

2}, Cassandra Kaizik^{1

2}, Olivier Piguet^{1

2}, John R Hodges^{2

5}

Affiliations

¹ School of Psychology University of Sydney Sydney New South Wales Australia.
² Brain and Mind Centre University of Sydney Sydney New South Wales Australia.
³ Law Health Justice Research Centre University of Technology Sydney Ultimo New South Wales Australia.
⁴ Neuroscience Research Australia Randwick New South Wales Australia.
⁵ Central Clinical School University of Sydney Sydney New South Wales Australia.

Abstract

Introduction: Some people with dementia develop changes in behaviour and cognition that may lead to interactions with police or the legal system. However, large, prospective case-control studies examining these behaviours are lacking.

Methods: One hundred and forty-four people with dementia and 53 controls completed the Misdemeanours and Transgressions Screener.

Results: Criminal risk behaviours were reported in: 65.6% of behavioural-variant frontotemporal dementia, 46.2% of right-lateralised semantic dementia, and 27.0% of Alzheimer's disease patients. In 19.1% of patients these behaviours led to contact with police or authority figures. Compared to controls, people with dementia showed higher rates of physical assault (p = 0.024), financial/professional recklessness (p = 0.009), and inappropriate behaviours (p = 0.052).

Discussion: Criminal risk behaviours are common across dementia subtypes and may be one of the first clinical signs of frontotemporal dementia. Further research to understand how to balance risk minimisation with an individual's liberties as well as the inappropriate criminalisation of people with dementia is needed.

Highlights: The Misdemeanours and Transgressions Screener is a new tool to assess criminal risk behaviours.Forty-seven percent of patients with dementia show criminal risk behaviour after dementia onset.Behaviours included verbal abuse, traffic violations, physical assault.New onset of criminal risk behaviours >50 years is a clinical sign for frontotemporal dementia.

Keywords: Alzheimer's disease; antisocial behaviour; criminal behaviour; frontotemporal dementia; law; legal; misdemeanours; right temporal variant frontotemporal dementia; semantic dementia; transgressions.