An older man takes a chocolate bar off the shelf in the supermarket and doesn’t pay for it. Or he drives riskily through a red light on an unfamiliar street. Later he cannot explain why he did what he did. For relatives, such situations seem confusing, embarrassing or even threatening. Scientists now know this could be an early warning sign of dementia.
The research team led by Matthias Schroeter and Lena Szabo from the “Max Planck Institute” (MPI) evaluated 14 studies in a broad meta-analysis, which together include more than 236,000 people from different countries such as Germany, USA, Sweden, Finland and Japan.
Suddenly a criminal? Half of those affected by FTD become noticeable early
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Their result: If criminal acts first occur in middle age or older, this can indicate the onset of dementia. Often such acts are not planned crimes, but rather impulsive actions. Such behavioral problems are particularly common in people with frontotemporal dementia (FTD), a disease that can occur in their 50s, as the data shows. Around half of those affected show criminal risk behavior in the early stages of the disease, often even as the first symptom.
The phenomenon is rarer in Alzheimer’s: only around ten percent of those affected show such behavioral changes; in Parkinson’s or vascular dementia the rate is even lower. Interestingly, criminal behavior tends to occur more frequently before diagnosis, after which it falls below the level of the general population. According to the researchers, the reason for this is that as the disease progresses, those affected tend to lose abilities rather than act impulsively.
Men more commonly affected
The meta-analysis also shows clear gender differences: Men with dementia show criminal behavior more often than women – four times more often in frontotemporal dementia and even seven times more in Alzheimer’s.
A complementary study by the MPI also examined the underlying brain changes. It was found that patients with criminal behavior had greater atrophy in the temporal lobe. This brain region controls, among other things, impulse control, social judgment and emotional regulation. In the communication, Schroeter speaks of a “disinhibition” that arises from the loss of these structures: those affected lose inhibitions and act impulsively, often without thinking through the consequences.
Criminal behavior can be an early symptom of dementia – experts warn against stigmatization
“With the meta-analysis, which is the first to systematically and quantitatively examine potential criminal behavior in dementia syndromes, we wanted to raise awareness of this problem. We hope that it contributes to a better understanding of the possible effects of such diseases, highlights possible causes and promotes interdisciplinary efforts to develop coping strategies,” explains Schroeter in a statement from the institute.
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If people unintentionally violate rules due to dementia, the legal system must take this into account. Schroeter emphasizes: “We must prevent further stigmatization of people with dementia. It is noteworthy that most of the crimes were minor offenses such as inappropriate behavior, traffic offenses, theft and damage to property, but physical violence or aggression also occurred. Therefore, sensitivity to this topic as possible early symptoms of dementia as well as early diagnosis and treatment are of utmost importance.”
