Resumen de Cognition and incarceration: cognitive impairment and its associated outcomes in older adults in jail
Cyrus Ahalt, Irena Stijacic Cenzer, Bruce L. Miller, Howard J. Rosen, Brie A. Williams, Deborah E. Barnes
Objectives To determine prevalence of, and outcomes associated with, a positive screen for cognitive impairment in older adults in jail.
Design Combined data from cross‐sectional (n=185 participants) and longitudinal (n=125 participants) studies.
Setting Urban county jail.
Participants Individuals in jail aged 55 and older (N = 310; mean age 59, range 55–80). Inclusion of individuals aged 55 and older is justified because the criminal justice system defines “geriatric prisoners” as those aged 55 and older.
Measurements Baseline and follow‐up assessments of health, psychosocial factors, and cognitive status (using the Montreal Cognitive Assessment (MoCA)); 6‐month acute care use and repeat arrest assessed in those followed longitudinally.
Results Participants were of low socioeconomic status (85% annual income < $15,000) and predominantly nonwhite (75%). Many (70%) scored less than 25 on the MoCA; those with a low MoCA score were more likely to be nonwhite (81% vs 62%, p<.001) and report fair or poor health (54% vs 41%, p=.04). Over 6 months, a MoCA score of less than 25 was associated with multiple emergency department visits (32% vs 13%, p=.02), hospitalization (35% vs 16%, p=.03), and repeat arrests (45% vs 21%, p=.01).
Conclusions Cognitive impairment is prevalent in older adults in jail and is associated with adverse health and criminal justice outcomes. A geriatric approach to jail‐based and transitional health care should be developed to assess and address cognitive impairment. Additional research is needed to better assess cognitive impairment and its consequences in this population. J Am Geriatr Soc 66:2065–2071, 2018.
