Dementia within the criminal system, from arrest through incarceration, has been largely ignored. While the health system has begun grappling with the chronic conditions that will accompany an aging society, the criminal system has yet to meaningfully respond. Dementia is a clinical syndrome characterized by impairment in cognitive domains (memory, executive function, visuospatial). Additionally, dementia often includes behavioral symptoms that increase the likelihood that an individual’s actions may violate social norms and in some circumstances be deemed criminal. Prior studies have established criminal behavior as a trend among individuals living with dementia. Yet, the criminal system has yet to establish protections for individuals who commit a crime while impaired by dementia. This paper will report on an empirical study to evaluate the treatment of persons with dementia within the criminal justice system. We will report on interviews with attorneys (n=15) regarding their experience and perspective on the treatment of persons with dementia post-arrest. In the paper, we will explore topics identified through these interviews including pre-trial release, competency, placement (housing), criminal liability determination, sentencing, and post-conviction release. We will highlight key findings including the lack of a systematic screening process for dementia post-arrest, placement is a significant challenge, attorneys’ lack of training on dementia to be able to understand how the disease could impact decision-making, and the two legal mechanisms available to divert miss the mark given their focus on psychiatric populations. We will use these data and findings to argue for a research and policy agenda to address a gap in legal policies to appropriately manage persons with dementia post-arrest.

中文翻译：

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犯罪、监禁和痴呆症：老化的刑事体系

刑事系统中的痴呆症，从逮捕到监禁，基本上都被忽视了。虽然卫生系统已经开始应对老龄化社会所带来的慢性病，​​但犯罪系统尚未做出有意义的反应。痴呆症是一种以认知领域（记忆、执行功能、视觉空间）受损为特征的临床综合征。此外，痴呆症通常包括行为症状，这些症状增加了个人行为违反社会规范的可能性，并在某些情况下被视为犯罪。先前的研究已确定犯罪行为是痴呆症患者的一种趋势。然而，刑事系统尚未为因痴呆症而犯罪的个人建立保护措施。本文将报告一项实证研究，以评估刑事司法系统内痴呆症患者的待遇。我们将报道对律师 (n=15) 的采访，了解他们对痴呆症患者被捕后的治疗的经验和看法。在本文中，我们将探讨通过这些访谈确定的主题，包括审前释放、能力、安置（住房）、刑事责任确定、量刑和定罪后释放。我们将重点强调关键发现，包括缺乏针对逮捕后痴呆症的系统筛查流程、安置是一项重大挑战、律师缺乏关于痴呆症的培训，无法了解该疾病如何影响决策，以及两种法律鉴于重点关注精神病人群，可用于转移注意力的机制并没有达到目标。我们将利用这些数据和调查结果来论证一项研究和政策议程，以解决法律政策方面的差距，以适当管理被捕后的痴呆症患者。