Abstract
Objectives:
To estimate the prevalence of dementia and mild cognitive impairment (MCI) in the older prisoner population in England and Wales, and to establish risk of harm to self and others, Activity of Daily Living needs and social networks of prisoners with likely MCI and dementia.
Design:
We screened 869 older prisoners (aged 50 years and older) using the Montreal Cognitive Assessment (MoCA). Participants testing positive on the MoCA (≤ 23) were interviewed using the Addenbrookes Cognitive Examination (ACE-III) and a range of standardised assessments were used risks of externalised violence and of self-harm; activities of daily living needs; mental health needs; history and symptoms of brain injury (if applicable); and social networks.
Setting:
The sample was drawn randomly from women’s prisons (n = 10) and a representative range of adult men’s prisons (n = 11) across England and Wales.
Participants:
Participants were aged 50 or over and resident in one of the participating prison establishments on the study’s census day.
Main Outcome Measure:
Addenbrookes Cognitive Examination – Third Revision (ACE-III)
Results:
We recruited 596 men and 273 women prisoners. Across the whole sample of older prisoners, the prevalence of dementia was 7.0% (CI 5.5, 8.9) (when weighted for sex and age), with the highest prevalence found amongst prisoners aged 70 years and older 11.8% (CI 8.0, 17.1). The prevalence of dementia for men was 7.0% (CI 5.2, 9.4) and for women was 6.0% (CI 3.8, 9.5). Only 2 individuals (3%) who screened positively on the MoCA had a diagnosis of dementia in their prison healthcare notes, suggesting current under-recognition. The prevalence of MCI was 0.8% (CI 0.4-1.7, weighted by age). Of those who screened positively on the MoCA, thirty-two (46%) participants had a high or very high risk of harm to self or others and seventy (35%) had no friends with whom they could talk to about private matters or to call on for help (n=35, 50%).
Conclusion:
Approximately 1020 older adults living in prison have symptoims of likely dementia and service provision for this group is inadequate.
To estimate the prevalence of dementia and mild cognitive impairment (MCI) in the older prisoner population in England and Wales, and to establish risk of harm to self and others, Activity of Daily Living needs and social networks of prisoners with likely MCI and dementia.
Design:
We screened 869 older prisoners (aged 50 years and older) using the Montreal Cognitive Assessment (MoCA). Participants testing positive on the MoCA (≤ 23) were interviewed using the Addenbrookes Cognitive Examination (ACE-III) and a range of standardised assessments were used risks of externalised violence and of self-harm; activities of daily living needs; mental health needs; history and symptoms of brain injury (if applicable); and social networks.
Setting:
The sample was drawn randomly from women’s prisons (n = 10) and a representative range of adult men’s prisons (n = 11) across England and Wales.
Participants:
Participants were aged 50 or over and resident in one of the participating prison establishments on the study’s census day.
Main Outcome Measure:
Addenbrookes Cognitive Examination – Third Revision (ACE-III)
Results:
We recruited 596 men and 273 women prisoners. Across the whole sample of older prisoners, the prevalence of dementia was 7.0% (CI 5.5, 8.9) (when weighted for sex and age), with the highest prevalence found amongst prisoners aged 70 years and older 11.8% (CI 8.0, 17.1). The prevalence of dementia for men was 7.0% (CI 5.2, 9.4) and for women was 6.0% (CI 3.8, 9.5). Only 2 individuals (3%) who screened positively on the MoCA had a diagnosis of dementia in their prison healthcare notes, suggesting current under-recognition. The prevalence of MCI was 0.8% (CI 0.4-1.7, weighted by age). Of those who screened positively on the MoCA, thirty-two (46%) participants had a high or very high risk of harm to self or others and seventy (35%) had no friends with whom they could talk to about private matters or to call on for help (n=35, 50%).
Conclusion:
Approximately 1020 older adults living in prison have symptoims of likely dementia and service provision for this group is inadequate.
| Original language | English |
|---|---|
| Article number | e095577 |
| Journal | BMJ Open |
| Volume | 15 |
| Early online date | 9 Apr 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 9 Apr 2025 |