Is your aging parent a ‘gentleman thief’? He may have dementia

gentleman thief

Burt Lancaster in Atlantic City. Jason Robards in Max Dugan Returns. Burt Lancaster and Kirk Douglas in Tough Guys. Al Pacino in The Godfather III (though the real criminal there was Ford Coppola).  All of these ‘old timers’ were born criminals, but if your aging father or mother turn to a life of petty crime after being decades of being law-abiding citizens, then they may have frontotemporal dementia. Some elderly adults with dementia inadvertently commit theft, trespassing, and other small-time crimes, and according to a new study in JAMA Neurology, a small number of those old people could be starting to experience mental deterioration, specifically a subtype of frontotemporal dementia.

This type of dementia is responsible or 10%-15% of all cases of dementia. Conversely, aging individuals with Alzheimer’s disease are much less likely to display this sort of “criminal behavior,” geriatrics specialist and professor of medicine at Weill Cornell Medical College in New York City Dr. Mark Lachs “wouldn't put a label of 'criminal behavior' on what is really a manifestation of a brain disease.” Dr. Lachs has studied aggressive behavior in dementia patients in nursing homes. In fact, episodes of violence toward others were not the norm; more often than not it was traffic violations. Either way, though, the behavior is a result of brain disease and not an actual crime. “It's not surprising that some patients with dementing illness would develop des-inhibiting behaviors that can be construed as criminal,” Lachs said.

 The study involved 2,400 patients at the Memory and Aging Center at the University of California, San Francisco, including 545 with Alzheimer’s disease and 171 with the variant of frontotemporal dementia that makes people lose control of their normal impulses. Of the latter, 37% had the highest rate of criminal behavior such as theft, traffic violations, trespassing and inappropriate sexual advances. On the other hand, only 8% of patients with Alzheimer’s displayed similar behavior like traffic violations and theft – including a confused elderly woman who ‘stole’ a pie from a grocery store, prompting the police to be called. However, there were also 11 cases of violence in this group.

Chairman of behavioral health at Winthrop-University Hospital in Mineola, N.Y Dr. Aaron Pinkhasov was not surprised by the findings, and explained that frontotemporal dementia affects the region of the brain that “basically filters our thoughts and impulses before we put them out into the world.” In contrast, Alzheimer’s affects areas in the back of the brain, taking a toll on memory and visual-spatial skills. At the same time, people with frontotemporal dementia often seem “cognitively intact,” said study researcher Dr. Georges Naasan, a Memory and Aging Center neurologist and clinical instructor. This ‘mask of sanity,’ if you will, can complicate the legal aspect. “They may be perceived by our current legal system as being 'responsible' for their action,” said Naasan. He and his colleagues found that criminal behavior was the first warning sign of dementia for 14% of frontotemporal dementia patients in the study.

Lachs added that families should be aware that this is a possibility. According to Naasan red flags should be raised if an aging parent experience changes in behavior or personality. These changes may or may not be caused by dementia, but a medical assessment “should at least be attempted.” As far as Alzheimer’s disease goes, Pinkhasov notes that behavioral issues or aggression may develop in later stages of this most common form of dementia. To Naasan, that means you can go Minority Report on your aging parent and prevent these “crimes” before they happen. “Maybe it's time to stop driving even before a traffic violation happens, if there is suspicion that the patient's judgment is clouded, and that behavior is impulsive,” he said. “These behaviors could be avoided with proper awareness, education and knowledge about the disease.” 

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