The mental and physical health of older offenders: A systematic review and meta-analysis

Solares, Carmen; Dobrosavljevic, Maja; Larsson, Henrik; Cortese, Samuele; Andershed, Henrik

doi:10.1016/j.neubiorev.2020.07.043

Cited by 20 publications

(20 citation statements)

References 70 publications

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“…Two recent systematic reviews, a meta-analysis and a scoping review attest to the high and specific health needs in older prisoners, as well as the need for further studies and age-appropriate programmes and interventions in countries outside of the USA and UK (Hagos et al , 2021; Merkt et al , 2020; Solares et al , 2020). Solares et al (2020) conducted meta-analyses of 55 eligible studies published until 2019 on the mental and physical health of older prisoners to find significantly elevated risk of hypertension, cardiovascular diseases, respiratory diseases and arthritis compared to non-prisoner samples. Importantly, significant heterogeneity was found between studies owing to country and sample characteristics, further supporting the need for country-specific analyses to inform appropriate policy responses.…”

Section: Age-related Health and Care Needs Of Older Prisonersmentioning

confidence: 99%

The ageing prisoner population: demographic shifts in Australia and implications for the economic and social costs of health care

Ginnivan

Chomik

Hwang

et al. 2021

IJPH

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Purpose The Australian prisoner population has experienced a dramatic increase in the number of older inmates over the past decade, consistent with the greying of the prisoner population that is being observed worldwide. Reviews suggest the need for further evidence and practice outside of the USA. This paper aims to review and discuss the cost and social implications of the rising health-care needs of this population in Australia. Design/methodology/approach A review of international research and policies is presented, as well as the results of basic economic modelling relating to the expected rise in health-care costs of the ageing prisoner population in Australia. Findings Taking into consideration the continued rise in incarceration rates, the calculations show that the health costs of prisoners could increase by anywhere between 17% and 90% depending on whether the increase of older prisoners continues as it has in the past decade. These trends are likely to continue over the next decade and will result in higher health costs of prisons under a number of different imprisonment scenarios. Policy responses in Australia have been slow so far, with most initiatives being undertaken in the USA with promising results. Practical implications The authors suggest that in the absence of a coordinated policy response, covering a range of interventions, costs will continue to increase, particularly as this population continues to age more rapidly than the general population due to an accumulation of risk factors. Well-conceived interventions would be a worthwhile investment from both financial and social perspectives. Originality/value To the best of the authors’ knowledge, this is the first commentary to acknowledge this rising public health issue and to both review and model its implications for the future.

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Section: Age-related Health and Care Needs Of Older Prisonersmentioning

confidence: 99%

The ageing prisoner population: demographic shifts in Australia and implications for the economic and social costs of health care

Ginnivan

Chomik

Hwang

et al. 2021

IJPH

View full text Add to dashboard Cite

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“…Recognising this requires investigating the individual profiles of patients in forensic mental health services and how patients’ backgrounds, characteristics, experiences and perspectives differ. This approach can be seen in recent efforts to develop services and interventions responsive to the lived experiences, strengths and needs of, amongst others, women patients ( de Vogel & Nicholls, 2016 ), culturally and ethnically diverse patients ( Hui, 2017 ), Deaf patients ( Wakeland et al ., 2019 ), and older patients ( Solares et al ., 2020 ). This latter group was the focus of the ENHANCE study 1 , which investigated the demographics, health-related quality of life, recovery rated quality of life, mental wellbeing, cognitive ability, wellbeing and secure hospital restrictiveness rating profiles of forensic mental healthcare patients aged 55 and over.…”

Section: Introductionmentioning

confidence: 99%

Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life

et al. 2022

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Background: Older individuals (e.g., 55 years and over) constitute a growing proportion of the forensic mental health patient population. As a group, they are vulnerable to health outcomes similar to other individuals with serious mental disorders of the same age; however, these concerns can be compounded by complex forensic-related care backgrounds and clinical presentations, lengthy periods of time spent in prison or psychiatric hospitals, substance use histories, and crime perpetration or victimisation. The healthcare needs and strengths of this group are not well understood. The aim of this study was to identify and describe the demographic, physical health, mental wellbeing, cognitive ability, and quality of life profiles of older forensic patients in community, low, medium, and high security settings in England. Methods: A cross-sectional quantitative study design was used. N=37 forensic patients aged 55 years and over completed six questionnaires. Data were also collected from patient records. Results: Most patients were male and were diagnosed with psychosis. The most frequently committed index offence types were violent offences. Patients were prescribed 7.6 medications on average and had average anticholinergic effect on cognition scores of 2.4. Nearly half the sample had diabetes, with an average BMI score of 31.7 (indicating obesity). Possible cognitive impairment was identified in 65% of the sample. Patients’ assessments of their recovery-related quality of life and mental wellbeing were comparable to published UK general population values. Assessments of quality of life were positively correlated with the ability to undertake everyday activities and cognitive performance. Conclusions: We suggest that forensic services are well-placed to provide holistic mental and physical care to this group but that they should co-develop with patients a greater range of age-appropriate meaningful activities that are mindful of mobility issues and consider implementing more cognition-based and physical health interventions.

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“…Indeed, deaths from physical disease are twice as likely among offenders compared with non-offenders [ 7 ]. Having a history of antisocial behavior is associated with multiple age-related conditions and diseases, including hypertension, diabetes, arthritis, cardiovascular diseases, respiratory diseases and cancer [ 6 , 8 ]. A major driver of such medical conditions is the process of aging itself [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Life-Course Persistent Antisocial Behavior and Accelerated Biological Aging in a Longitudinal Birth Cohort

Langevin

Caspi

Barnes

et al. 2022

IJERPH

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Prior research shows that individuals who have exhibited antisocial behavior are in poorer health than their same-aged peers. A major driver of poor health is aging itself, yet research has not investigated relationships between offending trajectories and biological aging. We tested the hypothesis that individuals following a life-course persistent (LCP) antisocial trajectory show accelerated aging in midlife. Trajectories of antisocial behavior from age 7 to 26 years were studied in the Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort (N = 1037). Signs of aging were assessed at age 45 years using previously validated measures including biomarkers, clinical tests, and self-reports. First, we tested whether the association between antisocial behavior trajectories and midlife signs of faster aging represented a decline from initial childhood health. We then tested whether decline was attributable to tobacco smoking, antipsychotic medication use, debilitating illnesses in adulthood, adverse exposures in childhood (maltreatment, socioeconomic disadvantage) and adulthood (incarceration), and to childhood self-control difficulties. Study members with a history of antisocial behavior had a significantly faster pace of biological aging by midlife, and this was most evident among individuals following the LCP trajectory (β, 0.22, 95%CI, 0.14, 0.28, p ≤ 0.001). This amounted to 4.3 extra years of biological aging between ages 25–45 years for Study members following the LCP trajectory compared to low-antisocial trajectory individuals. LCP offenders also experienced more midlife difficulties with hearing (β, −0.14, 95%CI, −0.21, −0.08, p ≤ 0.001), balance (β, −0.13, 95%CI, −0.18, −0.06, p ≤ 0.001), gait speed (β, −0.18, 95%CI, −0.24, −0.10, p ≤ 0.001), and cognitive functioning (β, −0.25, 95%CI, −0.31, −0.18, p ≤ 0.001). Associations represented a decline from childhood health. Associations persisted after controlling individually for tobacco smoking, antipsychotic medication use, midlife illnesses, maltreatment, socioeconomic status, incarceration, and childhood self-control difficulties. However, the cumulative effect of these lifestyle characteristics together explained why LCP offenders have a faster Pace of Aging than their peers. While older adults typically age-out of crime, LCP offenders will likely age-into the healthcare system earlier than their chronologically same-aged peers. Preventing young people from offending is likely to have substantial benefits for health, and people engaging in a LCP trajectory of antisocial behaviors might be the most in need of health promotion programs. We offer prevention and intervention strategies to reduce the financial burden of offenders on healthcare systems and improve their wellbeing.

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The mental and physical health of older offenders: A systematic review and meta-analysis

Cited by 20 publications

References 70 publications

The ageing prisoner population: demographic shifts in Australia and implications for the economic and social costs of health care

The ageing prisoner population: demographic shifts in Australia and implications for the economic and social costs of health care

Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life

Life-Course Persistent Antisocial Behavior and Accelerated Biological Aging in a Longitudinal Birth Cohort

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