Criminal Behavior More Likely in Frontotemporal Dementia

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Criminal behavior in middle-age or later in life may be an early sign of a behavioral variant of frontotemporal dementia, and should promote a medical examination for temporal brain disease or dementing disorders, according to a study published in JAMA Neurology.

Neurodegenerative diseases disrupt brain structures involved in judgment, executive function, emotional processing, sexual behavior, violence, and self-awareness, which can lead to anti-social and criminal behaviors that present later in life, reported Madeleine Liliegren, MD, of Lund University in Lund, Sweden, and colleagues.

The researchers reviewed medical records of 2,397 patients seen at the University of California San Francisco’s Memory and Aging Center between 1999 and 2012, of which 545 had Alzheimer’s, 171 had behavioral variant of frontotemporal dementia (bvFTD), 89 had semantic variant of primary progressive aphasia, and 30 had Huntington’s disease. In total, 8.5% (204) showed a history of criminal behavior during illness.

Among individual groups, 7.7% with Alzheimer’s, 37.4% with bvFTD, 27% with semantic variant of primary progressive aphasia, and 20% with Huntington’s disease exhibited criminal behavior during the illness. Fourteen percent of patients with bvFTD were more likely to have exhibited criminal behavior compared to 2% of patients with Alzheimer’s, while 6.4% with bvFTD were more likely to exhibit violence compared to 2% of patients with Alzheimer’s. Among the bvFTD group, common criminal activity included theft, sexual advances, trespassing, and public urination. The Alzheimer’s group more commonly committed traffic violations, likely due to cognitive impairment.

The researchers stressed that the legal system must address these occurrences in patients with a different approach than the typical “insanity defense” that’s often employed with patients who demonstrate mental instability and disease. 

Crime
Criminal Behavior More Likely in Frontotemporal Dementia

Neurodegenerative diseases can cause dysfunction of neural structures involved in judgment, executive function, emotional processing, sexual behavior, violence, and self-awareness. Such dysfunctions can lead to antisocial and criminal behavior that appears for the first time in the adult or middle-aged individual or even later in life.

Madeleine Liliegren, MD, of Lund University in Lund, Sweden, and colleagues conducted a retrospective medical record review of 2397 patients who were seen at the University of California, San Francisco, Memory and Aging Center between 1999 and 2012, including 545 patients with Alzheimer disease (AD), 171 patients with behavioral variant of frontotemporal dementia (bvFTD), 89 patients with semantic variant of primary progressive aphasia, and 30 patients with Huntington disease.

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