ARE RECENTLY INCARCERATED OLDER ADULTS MORE LIKELY TO DEVELOP DEMENTIA THAN THE NEVER INCARCERATED?

Abstract

Abstract Increasing numbers of older adults are reentering the community following incarceration (i.e., reentry). Yet, their risk of developing dementia and mild cognitive impairment (MCI) is unknown. We leveraged a national cohort of veterans who experienced reentry at age ≥ 65 years (N=5,920) and compared their risk of dementia or MCI to an age- and sex-matched never incarcerated sample (N=29,600). Those in the reentry sample were incarcerated for ≤10 consecutive years, experienced reentry between 10/01/2012 and 9/30/2018, and did not have a pre-incarceration MCI or dementia diagnosis per VA and CMS healthcare records (N=5,920). Fine-Gray models, controlling for race and pre-incarceration chronic conditions, serious mental illness, traumatic brain injury, and posttraumatic stress disorder, derived hazard ratios (HRs) and 95% Confidence Intervals (CIs). Samples were 99% male with average age 70 (±4.3) years. Reentry adults had a higher proportion of non-Whites (29% vs. 17%; p< 0.001) and more chronic conditions (2.1[±1.8] vs. 1.6[±1.6] p< 0.001). MCI incidence did not differ between reentry and never incarcerated groups (3.1% vs. 2.6%; HR=1.03; 95%CI 0.86-1.24). However, risk of any dementia was higher in reentry older adults (7.2% vs. 5.0%; HR=1.27; 95%CI 1.12, 1.44), as was risk of specific subtypes, e.g., vascular dementia (1.9% vs. 1.2%; HR=1.37; 95% CI 1.06-1.75) and frontotemporal dementia (0.2% vs. 0.1%; HR=2.3; 95% CI 1.2, 4.3). Those reentering the community in late life following incarceration may be a group that is especially at risk of developing dementia. These findings raise awareness of the need for appropriate transition planning for this vulnerable group.