New criminal behaviors, such as theft and violence, as well as sexual advances can be early manifestations of dementia, and the frequency and type of such behaviors may provide clues to the nature of the underlying neurodegenerative disorder, according to a new study by Liljegren and colleagues. Executive function, judgment, emotional processing and self-awareness may also be affected. Antisocial and criminal behavior may appear for the first time in the adult, middle-aged individual or later in life.
The study found that 14% of patients with behavioral variant frontotemporal dementia (bvFTD) were more likely to exhibit criminal behavior compared with 2% of Alzheimer’s disease patients. Common manifestations of criminal behavior in the bvFTD group included theft, traffic violations, sexual advances, trespassing, in contrast with those in the Alzheimer’s disease group, who commonly committed traffic violations, often related to cognitive impairment.
The study concluded that criminal behavior is more common in patients with behavioral variant frontotemporal dementia than in those with Alzheimer’s disease and is more likely to be an early manifestation of the disorder. The authors suggested that judicial evaluations of criminality in the demented individual might require different criteria than the classic “insanity defense” used in the American legal system. The appearance of new-onset criminal behavior in an adult should elicit a search for frontal and anterior temporal brain disease and for dementing disorders.
Liljegren M, Naasan G, Temlett J, Perry DC, Rankin KP, Merrilees J, Grinberg LT, Seeley WW, Englund E, Miller BL: Criminal Behavior in Frontotemporal Dementia and Alheimer Disease. JAMA Neurology [ Epub ahead of print, Jan. 5, 2015; doi:10.1001/jamaneurol.2014.3781 ].

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