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阿尔茨海默病和帕金森病杂志

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Dementia and Antisocial Behaviors

Michiho Sodenaga, ShinÂ’ya Tayoshi, Mioto Maedomari, Chiaki Hashimoto, Sachiko Tsukahara, Masanori Tadokoro and Koji Hori

Background: As the Japanese society ages, the number of elderly people with dementia who commit criminal offenses is also increasing. Through a retrospective study of medical records, we investigated the relationship between dementia and antisocial behaviors in 239 outpatients who visited our psychiatric department during a 2-year period.

Methods: We examined the medical records of outpatients of St. Marianna School of Medicine Hospital from April 2015 until March 2017: 152 with AD dementia (AD or AD+Vascular Dementia [VaD]), 19 with non-AD dementia (VaD, Lewy Body Dementia [LBD], FTD, alcohol-related dementia, organic dementia) and 24 controls without dementia. We investigated the incidence of antisocial behaviors and Behavioral and Psychological Symptoms of Dementia (BPSDs). We then compared their age, sex,, Hasegawa Dementia Scale-Revised (HDS-R) scores and the frequencies of antisocial behaviors and BPSDs using the chi-square test and analysis of variance.

Results: The frequency of antisocial behaviors among all dementia patients in our study was 6.4%, with no significant difference versus the controls. Analysis of variance revealed that the antisocial behavior, home invasion was significantly more common in the non-AD group (5.3%) than in the AD and control groups (both 0%, p<0.05) and was significantly different between the AD and non-AD groups (p<0.05).

Conclusion: We found a lower level of antisocial behaviors in people with dementia than reported in previous studies 7-9. The frequency of home invasion as an antisocial behavior and hallucinations and wandering as BPSDs was significantly higher in 1 patient with LBD (non-AD dementia). In this case, the hallucinations progressed to home invasion due to wandering. Antisocial behaviors with dementia mostly appear at the same time or after the development of BPSDs. Therefore, psychiatrists and caregivers should pay special attention to the treatment of BPSDs in patients with dementia to avoid the progression of these to antisocial behaviors.

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