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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
Örebro University, School of Behavioural, Social and Legal Sciences.ORCID iD: 0000-0001-6656-8836
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-4811-2330
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-3887-9669
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2023 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, no 1, article id 1915Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Nature Publishing Group, 2023. Vol. 13, no 1, article id 1915
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-104027DOI: 10.1038/s41598-023-28962-wISI: 000985266900053PubMedID: 36732577Scopus ID: 2-s2.0-85147318448OAI: oai:DiVA.org:oru-104027DiVA, id: diva2:1733729
Funder
EU, Horizon 2020, 754285The Swedish Brain Foundation, FO2021-0115Swedish Research Council, 2018-02599 2018-02213Available from: 2023-02-03 Created: 2023-02-03 Last updated: 2024-03-27Bibliographically approved
In thesis
1. The impact of criminal and externalizing behaviors on aging: Long-term associations with health and dementia
Open this publication in new window or tab >>The impact of criminal and externalizing behaviors on aging: Long-term associations with health and dementia
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Previous studies have shown that criminal and other externalizing behaviors are associated with several adverse outcomes, but very little is known about the impact of these behaviors beyond middle adulthood. Few studies have explored how a life-course background of criminal and externalizing behaviors influence aging and more specifically, whether it is associated with the onset and development of different neurodegenerative, mental, and physical health disorders when aging. The overarching aim of this dissertation is to advance the knowledge about the long-term influence that criminal and other externalizing behaviors along the lifespan may have on health and neurodegeneration while individuals age. This aim was explored throughout three studies: Study I, a systematic review and meta-analysis performed to investigate the prevalence of several mental and physical health problems of older offenders; Study II, a Swedish population-based register study which examined how the severity of the criminal background associated with dementia and mild cognitive impairment (MCI), and how several life-course factors influenced these associations and; Study III, a multi-generation cohort study investigating whether externalizing behaviors and dementia co-aggregate in families. The main findings suggest that older adults with criminal and externalizing behavioral backgrounds, and overall, those with a severe criminal history, exhibit an increased liability to develop physical and mental health problems as well as MCI and dementia when aging. This increased risk is influenced by life-course health and psychosocial problems as well as genetic and familial environmental factors. In general, findings from this thesis point towards a better understanding of the aging process of individuals with this background, and to further the scientific knowledge about the influence of life-course adverse behaviors on aging. This knowledge may promote the development of preventive and interventive strategies for individuals with a criminal and externalizing behavioral background.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2024. p. 96
Series
Örebro Studies in Psychology, ISSN 1651-1328 ; 48
Keywords
Older adults, aging, criminal behavior, externalizing behaviors, violent crime, dementia, Alzheimer's diseases, mental health, physical health, epidemiology
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-111219 (URN)9789175295411 (ISBN)9789175295428 (ISBN)
Public defence
2024-03-22, Örebro universitet, Hörsal M, Musikhögskolan, Fakultetsgatan 1, Örebro, 09:15 (English)
Opponent
Supervisors
Available from: 2024-01-30 Created: 2024-01-30 Last updated: 2024-05-02Bibliographically approved

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Solares, CarmenGarcia-Argibay, MiguelDobrosavljevic, MajaLarsson, HenrikAndershed, Henrik

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