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犯罪、死亡率与神经认知障碍:芬兰全国范围内的注册研究

Crime, mortality and neurocognitive disorders: A nationwide register study in Finland.

机构信息

Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.

出版信息

Int J Methods Psychiatr Res. 2023 Jun;32(2):e1948. doi: 10.1002/mpr.1948. Epub 2022 Sep 30.

Abstract

OBJECTIVES

To explore mortality of patients with Alzheimer's disease (AD), frontotemporal dementia (FTD), or Lewy body dementias (LBD) who had criminal behavior in the year preceding diagnosis.

METHODS

Data were obtained from the nationwide registers. Mortality was compared between disorder groups with and without criminal acts and with the general population. The cohort included patients who had received a discharge register diagnosis of AD (N = 80,540), FTD (N = 1060), or LBD (N = 10,591) between 1998 and 2015. The incidences of crimes were calculated in the year preceding diagnosis. We further calculated age- and sex-adjusted survivals of different dementia groups with and without criminal acts, and in relation to the general population (SMR, Standardized Mortality Ratio).

RESULTS

Criminal behavior was more common in men than in women. It was associated with decreased mortality in the AD group. SMRs due to unnatural causes, and in the LBD and FTD female groups, were higher in patients with criminal behavior than in those without.

CONCLUSION

LBD and female FTD patients, who had criminal behavior before diagnosis, were at higher risk of death than patients without such behavior. Novel criminality in older adults may be associated with neurocognitive disorder, in which case medical attention is justified.

摘要

目的

探讨在诊断前一年有犯罪行为的阿尔茨海默病(AD)、额颞叶痴呆(FTD)或路易体痴呆(LBD)患者的死亡率。

方法

数据来自全国登记处。在有和没有犯罪行为的障碍组之间以及与普通人群进行死亡率比较。该队列包括 1998 年至 2015 年间接受 AD(N=80540)、FTD(N=1060)或 LBD(N=10591)出院诊断的患者。在诊断前一年计算犯罪发生率。我们进一步计算了有和没有犯罪行为的不同痴呆组的年龄和性别调整后的生存率,并与普通人群(SMR,标准化死亡率比)进行了比较。

结果

犯罪行为在男性中比女性更常见。它与 AD 组死亡率降低有关。有犯罪行为的 LBD 和 FTD 女性组的非自然原因死亡率以及 SMR 高于无犯罪行为的患者。

结论

在诊断前有犯罪行为的 LBD 和女性 FTD 患者的死亡风险高于没有此类行为的患者。老年患者的新犯罪行为可能与神经认知障碍有关,在这种情况下,需要进行医疗关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c565/10242203/88bf6ac9bfaa/MPR-32-e1948-g001.jpg

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