POSSIBILITY OF UNDIAGNOSED DEMENTIA PATIENTS ARRESTED FOR VIOLENT BEHAVIOUR IN JAPAN

Abstract

Arrests by the police consists a basic violation of human rights, and should be kept to a necessary minimum. In Japan, although the total number of arrests of persons over 65 has been declining, it is the only age group in which arrests for violent acts has increased. If this development is in any way due to the increasing cases of dementia, a system that takes the possibility of dementia into consideration and protects the rights of living well with dementia is needed urgently. We have surveyed the details of violent acts by 211 consecutive new dementia out-patients in our Medical Centre, between January, 2016 and December, 2016. Of 211 new outpatients, 12.8% (n=27) exhibited physical violence, and 27.0%（n=57） exhibited verbal violence. These accounted for 31 of 130 patients (23.8%) with AD, 9 of 41 patients (22.0%) with MCI, 7 of 27 patients (25.9%) with VD, 1 of 9 patients (11.1%) with DLB, none of 3 patients (0.00%) with bvFTD exhibited verbal violence. 5 of 12 patients (41.7%) with psychoactive substance use (alcohol, benzodiazepines) exhibited verbal violence while none of 21 patients (0.00%) within normal cognitive aging did. Most occurrences of aggressive behaviour did not involve serious violence, and were entered into impulsively. The impulsive nature of these acts is more likely to be connected to vulnerability in the frontal lobe of dementia. This further suggests the possibility that much of the violent behaviour for which persons over 65 are arrested is also similarly impulsive in nature, and includes acts by patients of undiagnosed dementia or MCI. If dementia patients are being arrested for violent behaviour without understanding of their condition, this suggests the necessity for a system that protects the rights and interests of these individuals.