Haußmann R, Krug C, Noppes F, Brandt M, Lange J, Donix M
Universitäts Demenz Centrum (UDC), Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Nervenarzt. 2022 Jan;93(1):59-67. doi: 10.1007/s00115-021-01070-8. Epub 2021 Feb 11.
Criminal behavior in older people represents a rare phenomenon. Among older criminals there are many first offenders and 75% are men. Dementia poses one possible origin of delinquency in advanced age. It is unclear how often dementia is the actual cause of delinquency in older age. In studies with older criminals the prevalence of dementia was heterogeneous due to methodological study issues. In the course of the disease 50% of patients with frontotemporal dementia and 10% of patients with Alzheimer's disease commit crimes. The neurobiological origin of delinquency in dementia is poorly understood. On the basis of current study results first delinquency in older age can be explained by impairment of social cognition, difficulties in making appropriate emotional contributions and disturbed control of behavior. Affection of frontal and anterior temporal brain structures seem to be of high relevance. As dementia impairs criminal responsibility psychiatrists are confronted with a forensic evaluation of legal culpability of older criminals. Regarding different etiologies of dementia, specific peculiarities need to be considered in a forensic psychiatric assessment. Especially frontotemporal dementia predisposes towards a wide spectrum of criminal behavior whereas patients with Alzheimer's disease predominantly commit crimes due to cognitive impairment. The review summarizes the present knowledge about criminal behavior in the context of dementia.
老年人的犯罪行为是一种罕见现象。在老年罪犯中，初犯者众多，且75%为男性。痴呆症是高龄犯罪的一个可能根源。目前尚不清楚痴呆症在老年犯罪中实际导致犯罪的频率有多高。在针对老年罪犯的研究中，由于研究方法问题，痴呆症的患病率存在差异。在疾病过程中，50%的额颞叶痴呆患者和10%的阿尔茨海默病患者会犯罪。痴呆症中犯罪行为的神经生物学根源尚不清楚。根据目前的研究结果，老年初犯可归因于社会认知受损、做出适当情感反应困难以及行为控制紊乱。额叶和颞叶前部脑结构的病变似乎具有高度相关性。由于痴呆症会损害刑事责任能力，精神科医生面临着对老年罪犯法律罪责的法医评估。对于不同病因的痴呆症，在法医精神病学评估中需要考虑特定的特点。特别是额颞叶痴呆易导致广泛的犯罪行为，而阿尔茨海默病患者主要因认知障碍而犯罪。本综述总结了目前关于痴呆症背景下犯罪行为的知识。
