From: hounddog23x@gmail.com   
      
   Breaking the law may be a sign of dementia   
      
   By Kathryn Doyle   
   Mon Jan 5, 2015 3:49pm EST   
      
   By Kathryn Doyle   
      
   (Reuters Health) - Criminal behavior in older adults, including theft, traffic   
   violations, sexual advances, trespassing, and public urination, may be a sign   
   of dementia, researchers say.   
      
   There is a subgroup of people, especially older adults who are first-time   
   offenders, who may have a degenerative brain disease underlying their criminal   
   behavior, said Dr. Georges Naasan of the Memory and Aging Center and   
   Department of Neurology at the    
   University of California, San Francisco.   
      
   He and his coauthors reviewed the medical records of 2,397 patients diagnosed   
   with Alzheimer's disease or other types of dementia between 1999 and 2012.   
   They scanned patient notes for entries about criminal behavior using keywords   
   like 'arrest,' 'DUI,' '   
   shoplift' and 'violence' and uncovered 204 patients, or 8.5 percent, who   
   qualified.   
      
   Their behaviors were more often an early sign of frontotemporal dementia   
   (bvFTD) or primary progressive aphasia (PPA), a type of language-deteriorating   
   dementia, than of Alzheimer's disease.   
      
   Of the 'criminal' group, 64 had bvFTD, 24 had PPA, 42 had Alzheimer's, and the   
   rest had various other forms of dementia.   
      
   Patients with bvFTD or PPA tended to be younger, averaging 59 to 63 years old,   
   compared to Alzheimer's patients, who were an average age of 71, when their   
   doctors made notes about criminal behaviors.   
      
   More than 6.4 percent of those in the "criminal group" with bvFTD exhibited   
   physical or verbal violence during their illness, compared to 3.4 percent of   
   those with PPA and two percent of those with Alzheimer's disease, the   
   researchers reported in JAMA    
   Neurology.   
      
   For four percent of patients with bvFTD, violence was one of the first   
   symptoms of their brain disease.   
      
   Men were considerably more likely than women to make sexual advances to others   
   and to urinate in public.   
      
   If patients have a family history of the neurodegenerative disease, it may be   
   possible to connect new criminal behavior to an underlying problem with the   
   brain, Naasan said.   
      
   "However, most of these diseases are 'sporadic' meaning that they occur for no   
   identifiable genetic cause and it is difficult to predict," he said. "In   
   general, an early detection of changes in personality, deviation from what   
   constituted a 'norm' for a    
   particular individual, should prompt an evaluation for possible brain causes."   
      
   Early signs of bvFTD can include personality changes including disinhibition,   
   lack of empathy, loss of motivation or apathy, or obsessive-compulsive   
   behavior, he said.   
      
   "It is sometimes hard to wrap our minds around the concept that a specific   
   part of our brain is not functioning properly, leading to behaviors that may   
   range the gamut of disruptive, detached and sometimes criminal," Naasan said.   
      
   Family and friends can easily take these behavior changes personally, but they   
   should understand that it may be the first sign of a disease and should   
   request a medical evaluation, he said.   
      
   "The amoral conduct seen in FTD spectrum disorders strikes the examiner as   
   patient's deliberate choice, these individuals seem selfish and temperamental   
   with little regard for their worried and frustrated family members," said Dr.   
   Adonis Sfera, staff    
   psychiatrist at Patton State Hospital in Orange County, California, who was   
   not part of the new research.   
      
   "As their behavior looks like mental illness, some of these people end up   
   admitted in psychiatric hospitals, while others are imprisoned or placed in   
   state psychiatric hospitals after being diagnosed with antisocial personality   
   disorder," Sfera told    
   Reuters Health by email.   
      
   It's difficult to say how much crime may be due to these types of causes,   
   Naasan told Reuters Health by email.   
      
   He and his colleagues did not survey criminal records and so they can't say   
   what percentage of all people who commit crimes have neurological disorders.   
      
   Health care providers are not usually familiar with FTD, and frequently   
   misdiagnose it as bipolar disorder or late onset schizophrenia, he added.   
      
   FTD spectrum disorders can be accurately diagnosed with so-called PET scans   
   (positron emission tomography) and neuropsychological testing, "but only if we   
   think of it," Naasan said.   
      
   SOURCE: http://bit.ly/1xLrXw4 JAMA Neurology, January 5, 2015.   
      
      
   http://mobile.reuters.com/article/idUSKBN0KE1Q020150105?irpc=932   
      
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