Prevalence of dementia and mild cognitive impairment among the older prisoner population in England and Wales: a cross-sectional study
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 screene...
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BMJ Publishing Group
2025-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/4/e095577.full |
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| author | Richard Emsley Alistair Burns Jane Senior Roger Webb Katrina Forsyth Matthew J Carr Baber Malik Leanne Heathcote Laura Archer-Power Rachel Domone Salman Karim Adrian Hayes Jennifer Shaw |
| author_facet | Richard Emsley Alistair Burns Jane Senior Roger Webb Katrina Forsyth Matthew J Carr Baber Malik Leanne Heathcote Laura Archer-Power Rachel Domone Salman Karim Adrian Hayes Jennifer Shaw |
| author_sort | Richard Emsley |
| collection | DOAJ |
| description | 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 Addenbrooke’s Cognitive Examination, Third Revision (ACE-III) and a range of standardised assessments were used to assess 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 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% (95% CI 5.5%, 8.9%) (when weighted for sex and age), with the highest prevalence found among prisoners aged 70 years and older at 11.8% (95% CI 8.0%, 17.1%). The prevalence of dementia for men was 7.0% (95% CI 5.2%, 9.4%) and for women was 6.0% (95% CI 3.8%, 9.5%). Only two 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% (95% CI 0.4% to 1.7%, weighted by age). Of those who screened positively on the MoCA, 32 (46%) participants had a high or very high risk of harm to self or others, and 70 (35%) had no friends with whom they could talk to about private matters or to call on for help (n=35, 50%).Conclusions Approximately 1020 older adults living in prison have symptoms of likely dementia, and service provision for this group is inadequate. |
| format | Article |
| id | doaj-art-949d8666e50b4aaa8d9f1663273132b3 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-949d8666e50b4aaa8d9f1663273132b32025-08-20T03:05:22ZengBMJ Publishing GroupBMJ Open2044-60552025-04-0115410.1136/bmjopen-2024-095577Prevalence of dementia and mild cognitive impairment among the older prisoner population in England and Wales: a cross-sectional studyRichard Emsley0Alistair Burns1Jane Senior2Roger Webb3Katrina Forsyth4Matthew J Carr5Baber Malik6Leanne Heathcote7Laura Archer-Power8Rachel Domone9Salman Karim10Adrian Hayes11Jennifer Shaw125 Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK9 Department of Psychiatry and Behavioural Sciences, University of Manchester, Manchester, UK6 University of Manchester, Manchester, UK2 School of Community Based Medicine, The University of Manchester, Manchester, UK1 The University of Manchester, Manchester, UK6 University of Manchester, Manchester, UK1 The University of Manchester, Manchester, UK3 Health & Justice Research Network, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK4 Lancashire Police, Manchester, UK7 Lancashire Care NHS Foundation Trust, Preston, UK7 Lancashire Care NHS Foundation Trust, Preston, UK8 Somerset Partnership NHS Foundation Trust, Taunton, UK10 Offender Health Research Network, University of Manchester, Manchester, UKObjectives 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 Addenbrooke’s Cognitive Examination, Third Revision (ACE-III) and a range of standardised assessments were used to assess 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 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% (95% CI 5.5%, 8.9%) (when weighted for sex and age), with the highest prevalence found among prisoners aged 70 years and older at 11.8% (95% CI 8.0%, 17.1%). The prevalence of dementia for men was 7.0% (95% CI 5.2%, 9.4%) and for women was 6.0% (95% CI 3.8%, 9.5%). Only two 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% (95% CI 0.4% to 1.7%, weighted by age). Of those who screened positively on the MoCA, 32 (46%) participants had a high or very high risk of harm to self or others, and 70 (35%) had no friends with whom they could talk to about private matters or to call on for help (n=35, 50%).Conclusions Approximately 1020 older adults living in prison have symptoms of likely dementia, and service provision for this group is inadequate.https://bmjopen.bmj.com/content/15/4/e095577.full |
| spellingShingle | Richard Emsley Alistair Burns Jane Senior Roger Webb Katrina Forsyth Matthew J Carr Baber Malik Leanne Heathcote Laura Archer-Power Rachel Domone Salman Karim Adrian Hayes Jennifer Shaw Prevalence of dementia and mild cognitive impairment among the older prisoner population in England and Wales: a cross-sectional study BMJ Open |
| title | Prevalence of dementia and mild cognitive impairment among the older prisoner population in England and Wales: a cross-sectional study |
| title_full | Prevalence of dementia and mild cognitive impairment among the older prisoner population in England and Wales: a cross-sectional study |
| title_fullStr | Prevalence of dementia and mild cognitive impairment among the older prisoner population in England and Wales: a cross-sectional study |
| title_full_unstemmed | Prevalence of dementia and mild cognitive impairment among the older prisoner population in England and Wales: a cross-sectional study |
| title_short | Prevalence of dementia and mild cognitive impairment among the older prisoner population in England and Wales: a cross-sectional study |
| title_sort | prevalence of dementia and mild cognitive impairment among the older prisoner population in england and wales a cross sectional study |
| url | https://bmjopen.bmj.com/content/15/4/e095577.full |
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