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Risk of dementia and mild cognitive impairment in older adults with a criminal background: a population-based register study in Sweden

Risk of dementia and mild cognitive impairment in older adults with a criminal background: a population-based register study in Sweden
Risk of dementia and mild cognitive impairment in older adults with a criminal background: a population-based register study in Sweden

Criminal behaviour has previously been associated with an increased risk for several mental health problems, but little is known about the association between criminal behaviour and dementia. We aimed to examine how the criminal background (type of crime, number of convictions, length of the sentence) is associated with dementia and mild cognitive impairment (MCI), and how mental and physical health disorders and educational attainment influenced these associations. A nationwide cohort of 3,617,028 individuals born between 1932 and 1962 were linked with criminal and medical records using Swedish national registers. We used Cox regression models to examine the associations. Increased risks for dementia (Hazard ratios (HRs) 1.54, 95% confidence interval (CI) 1.50-1.57) and MCI (1.55, 1.50-1.61) were found in individuals with criminal background, particularly among those who committed violent or several crimes, or with long sentences. After full adjustment of covariates, the associations attenuated but remained statistically significant for dementia (1.25, 1.22-1.28) and MCI (1.27, 1.22-1.32). The attenuation was mostly explained by mental health problems -depression, anxiety, schizophrenia spectrum disorders, substance use disorder (SUD), and bipolar disorder- (dementia: 1.34, 1.31-1.37; MCI: 1.35, 1.30-1.40). SUD contributed the most to attenuate the associations. Our results may provide important insights to health and penal systems by showing the importance of considering the severity of the criminal background and life-course mental health when assessing the risk of neurodegenerative disorders.

Humans, Aged, Violence/psychology, Sweden/epidemiology, Criminals, Risk Factors, Crime, Substance-Related Disorders, Cognitive Dysfunction/epidemiology, Dementia/epidemiology
2045-2322
Solares, Carmen
d2f8a22d-e302-41c6-af9a-2c979b247655
Garcia-Argibay, Miguel
e5a6941e-4dcc-401a-9de4-09557c8856ef
Chang, Zheng
86831bee-800b-469f-b67f-a5b7790cef80
Dobrosavljevic, Maja
6f9de5ec-d360-4fd2-acfc-b24b82c03dd5
Larsson, Henrik
1d1c897c-ad54-4ffc-bf84-46b2a57f5bf4
Andershed, Henrik
f73fc2c1-c3a4-4964-ac16-4b2443c2a3bd
Solares, Carmen
d2f8a22d-e302-41c6-af9a-2c979b247655
Garcia-Argibay, Miguel
e5a6941e-4dcc-401a-9de4-09557c8856ef
Chang, Zheng
86831bee-800b-469f-b67f-a5b7790cef80
Dobrosavljevic, Maja
6f9de5ec-d360-4fd2-acfc-b24b82c03dd5
Larsson, Henrik
1d1c897c-ad54-4ffc-bf84-46b2a57f5bf4
Andershed, Henrik
f73fc2c1-c3a4-4964-ac16-4b2443c2a3bd

Solares, Carmen, Garcia-Argibay, Miguel, Chang, Zheng, Dobrosavljevic, Maja, Larsson, Henrik and Andershed, Henrik (2023) Risk of dementia and mild cognitive impairment in older adults with a criminal background: a population-based register study in Sweden. Scientific Reports, 13 (1), [1915]. (doi:10.1038/s41598-023-28962-w).

Record type: Article

Abstract

Criminal behaviour has previously been associated with an increased risk for several mental health problems, but little is known about the association between criminal behaviour and dementia. We aimed to examine how the criminal background (type of crime, number of convictions, length of the sentence) is associated with dementia and mild cognitive impairment (MCI), and how mental and physical health disorders and educational attainment influenced these associations. A nationwide cohort of 3,617,028 individuals born between 1932 and 1962 were linked with criminal and medical records using Swedish national registers. We used Cox regression models to examine the associations. Increased risks for dementia (Hazard ratios (HRs) 1.54, 95% confidence interval (CI) 1.50-1.57) and MCI (1.55, 1.50-1.61) were found in individuals with criminal background, particularly among those who committed violent or several crimes, or with long sentences. After full adjustment of covariates, the associations attenuated but remained statistically significant for dementia (1.25, 1.22-1.28) and MCI (1.27, 1.22-1.32). The attenuation was mostly explained by mental health problems -depression, anxiety, schizophrenia spectrum disorders, substance use disorder (SUD), and bipolar disorder- (dementia: 1.34, 1.31-1.37; MCI: 1.35, 1.30-1.40). SUD contributed the most to attenuate the associations. Our results may provide important insights to health and penal systems by showing the importance of considering the severity of the criminal background and life-course mental health when assessing the risk of neurodegenerative disorders.

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Accepted/In Press date: 27 January 2023
Published date: 2 February 2023
Keywords: Humans, Aged, Violence/psychology, Sweden/epidemiology, Criminals, Risk Factors, Crime, Substance-Related Disorders, Cognitive Dysfunction/epidemiology, Dementia/epidemiology

Identifiers

Local EPrints ID: 489084
URI: http://eprints.soton.ac.uk/id/eprint/489084
ISSN: 2045-2322
PURE UUID: ba49f27b-62db-4c1f-a96d-228fbd59585f
ORCID for Miguel Garcia-Argibay: ORCID iD orcid.org/0000-0002-4811-2330

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Date deposited: 12 Apr 2024 17:00
Last modified: 29 May 2024 02:09

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Contributors

Author: Carmen Solares
Author: Miguel Garcia-Argibay ORCID iD
Author: Zheng Chang
Author: Maja Dobrosavljevic
Author: Henrik Larsson
Author: Henrik Andershed

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