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The impact of criminal and externalizing behaviors on aging: Long-term associations with health and dementia
Örebro University, School of Behavioural, Social and Legal Sciences.ORCID iD: 0000-0001-6656-8836
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 [en]
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: urn:nbn:se:oru:diva-111219ISBN: 9789175295411 (print)ISBN: 9789175295428 (electronic)OAI: oai:DiVA.org:oru-111219DiVA, id: diva2:1832703
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
List of papers
1. The mental and physical health of older offenders: A systematic review and meta-analysis
Open this publication in new window or tab >>The mental and physical health of older offenders: A systematic review and meta-analysis
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2020 (English)In: Neuroscience and Biobehavioral Reviews, ISSN 0149-7634, E-ISSN 1873-7528, Vol. 118, p. 440-450Article, review/survey (Refereed) Published
Abstract [en]

A systematic review with meta-analysis was performed to: 1) estimate the prevalence of both mental and physical health problems in older offenders; 2) calculate relative risks for the health conditions in relation to non-offender older adults and; 3) explore the potential confounding role of several variables. We searched five databases up to August 2019. Studies involving offenders older than 50 years old were included. Fifty-five publications met criteria. The pooled prevalence for 18 mental and 28 physical health problems was calculated. In comparison with non-offender older adults, older offenders showed significantly higher risk for Hypertension (RR = 1.16, CI = 1.1, 1.2), Cardiovascular Diseases (RR = 1.24, CI = 1.09, 1.41), Respiratory diseases (RR = 1.75, CI = 1.29, 2.35), and Arthritis (RR = 1.19, CI = 1.12, 1.25). Heterogeneity was significant for all meta-analyses and partially explained by the confounding effect of country, the diagnosis assessment method, and the sample characteristics. Future research should include comparison groups of non-offender older adults and use longitudinal study designs to identify risk factors that can be targeted in preventive programmes.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Aging, Older offenders, Criminal behavior, Mental health, Physical health
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-85155 (URN)10.1016/j.neubiorev.2020.07.043 (DOI)000620164200033 ()32783970 (PubMedID)2-s2.0-85089754833 (Scopus ID)
Funder
EU, Horizon 2020, 754285
Available from: 2020-08-25 Created: 2020-08-25 Last updated: 2024-02-26Bibliographically approved
2. Risk of dementia and mild cognitive impairment in older adults with a criminal background: a population-based register study in Sweden
Open this publication in new window or tab >>Risk of dementia and mild cognitive impairment in older adults with a criminal background: a population-based register study in Sweden
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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
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-104027 (URN)10.1038/s41598-023-28962-w (DOI)000985266900053 ()36732577 (PubMedID)2-s2.0-85147318448 (Scopus ID)
Funder
EU, Horizon 2020, 754285The Swedish Brain Foundation, FO2021-0115Swedish Research Council, 2018-02599 2018-02213
Available from: 2023-02-03 Created: 2023-02-03 Last updated: 2024-03-27Bibliographically approved
3. Externalizing Behaviors and Alzheimer's Disease and Any Dementia: A Multigeneration Cohort Study in Sweden
Open this publication in new window or tab >>Externalizing Behaviors and Alzheimer's Disease and Any Dementia: A Multigeneration Cohort Study in Sweden
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2023 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 7, no 9, article id igad117Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVES: We examined the extent to which externalizing behaviors such as violent and nonviolent criminal behavior, and substance use disorders (SUD) are associate with the onset of Alzheimer's disease (AD) and any dementia in prior generations.

RESEARCH DESIGN AND METHODS: A nationwide cohort of 2,463,033 individuals born between 1973 and 1997 (index persons) were linked to their biological relatives (parents, grandparents, and uncles/aunts) using Swedish national registers. Cox regression models were used to examine the association between each measure of externalizing behaviors with AD and any dementia in each of the relative cohorts.

RESULTS: Parents of index persons with externalizing behaviors had an increased risk for AD compared with parents of index persons without externalizing behaviors-nonviolent criminal behavior: Hazard Ratio (HR) = 1.16, 95% Confidence Intervals (CI) 1.10-1.22; violent criminal behavior: HR = 1.32 (95% CI: 1.19-1.45); SUD: HR = 1.28 (95% CI: 1.17, 1.40). The associations attenuated with decreasing familial relatedness. Relatives of individuals with externalizing behaviors compared with relatives of individuals without, showed an increased risk of having both early-onset and late-onset AD but the strength of the associations was higher for early-onset AD than for late-onset AD. A similar pattern of results was observed for the association with any dementia.

DISCUSSION AND IMPLICATIONS: Externalizing behaviors are associated with AD and any dementia in prior generations. The associations were stronger for parents in comparison with grandparents and uncles/aunts, suggesting shared familial risks between conditions. This warrants further studies examining common genetic and family-wide environmental factors that may contribute to identifying common underlying mechanisms to the development of externalizing behaviors, AD, and any dementia.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
Criminal behavior, Epidemiology, Family design, Major neurodegenerative disorders, Substance abuse
National Category
Neurosciences
Identifiers
urn:nbn:se:oru:diva-109961 (URN)10.1093/geroni/igad117 (DOI)001106048000002 ()38024330 (PubMedID)2-s2.0-85178100452 (Scopus ID)
Funder
EU, Horizon 2020, 754285Swedish Research Council, 2018-02599; 2018-02213; 2021-06370The Swedish Brain Foundation, FO2021-0115
Available from: 2023-11-30 Created: 2023-11-30 Last updated: 2024-02-26Bibliographically approved

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