- Published: November 14, 2012
Alzheimer's disease and other forms of dementia are characterized as neurodegenerative diseases that affect cognitive functioning such as memory, thinking, and behavior. According to the National Institute of Health, at least 5 million Americans currently have Alzheimer’s, which increases in risk with age. Symptoms of dementia vary, but as the disease advances, symptoms include “forgetting details and events, hallucinations, depression, arguments, agitation, and violent behavior” (Florida Hospital Neuroscience Institute). Studies, including a 1987 study in the Journal of Clinic Psychiatry, suggest that up to 30 percent of outpatients with Alzheimer’s disease exhibit violent behavior. Furthermore, a CNN report detailed various instances in which Alzheimer’s patients exhibited violent, antisocial behavior. This report acknowledged that 5% to 10% of patients with Alzheimer’s were known to have violent behavior. How can neuroscience and a scientific understanding of such behavior inform, treat, and correct dementia patients inside and outside of the courtroom?
A presentation titled “The Neurobiology of Aggression and Violence,” given by Dr. Christopher Filley (University of Colorado Denver School of Medicine) details the various literature-based characteristics relating to dementia and violence. Citing well-established neurocognitive research, Filley underscored that “violence occurs when frontal inhibition cannot control limbic impulses,” and this becomes a significant concern with neurodegenerative disease. With an extensive literature overview, Filley noted that agitation is a manifestation of frontal lobe dysfunction (Miller et al), and that another study found 40% of subjects with Alzheimer’s and vascular dementia to display agitation (Ballard et al.). Such studies have pointed to frontal lobe dysfunction in dementia patients that results in antisocial behavior, ranging from assault to shoplifting to even “hit-and-run driving,” and that this behavior and “did not occur before dementia developed” (Filley et al.).
Such an area of concern involves criminal behavior with neurological underpinnings, some of which may be argued aren’t in the hands of the dementia patient. With violent behavior that can lead to crimes and court proceedings, it has become clear that advocacy from the fields of neuroscience and neurology should be adopted in order to advise court proceedings with regards to understanding of behavior, consideration of mens rea, and decision to sentence the accused to a forward-looking treatment. The case of dementia patients provides yet another example in which a scientifically-substantiated understanding of behavior and physiology will be key in determining culpability and suitable sentencing.
Reisberg B, Borenstein J, Salob SP, et al. Behavioral symptoms in Alzheimer’s disease: phenomenology and treatment. J Clin Psychiatry. 1987;48(suppl5):9–15.
Presentation: The Neurobiology of Aggression and Violence. Christopher M. Filley, M.D.
Park, Madison. "When Alzheimer's Turns Violent." CNN. Cable News Network, 30 Mar. 2011. Web. 14 Nov. 2012. <http://www.cnn.com/2011/HEALTH/03/30/alzheimers.violence.caregiving/index.html>.