Defining an age cut-off for older offenders: a systematic review of literature

• Published date: 09 April 2020
• Pages: 95-116
• DOI: https://doi.org/10.1108/IJPH-11-2019-0060
• Date: 09 April 2020
• Author: Helene Merkt,Sophie Haesen,Leila Meyer,Reto W. Kressig,Bernice S. Elger,Tenzin Wangmo
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Defining an age cut-off for older offenders:

a systematic review of literature

Helene Merkt, Sophie Haesen, Leila Meyer, Reto W. Kressig, Bernice S. Elger and

Tenzin Wangmo

Abstract

Purpose –In the literature, 65years is commonly used as the age to designate an older person in the

community. When studying older prisoners, there is much variation. The purpose of this paper is to

investigatehow researchers define older offendersand for what reasons.

Design/methodology/approach –The authors reviewed articles on health and well-being of older

offenders to assessterminology used to describe this age group, the chosen age cut-offsdistinguishing

younger offenders from older offenders, the arguments provided to support this choice as well as the

empiricalbase cited in this context.

Findings –The findings show that the age cut-offof 50 years and the term ‘‘older’’ were most frequently

used by researchers in the field.The authors find eight main arguments givento underscore the use of

specific age cut-offsdelineating older offenders. They outline thereasoning provided for each argument

and evaluateit for its use to define older offenders.

Originality/value –With this review, it is hoped to stimulate the much-needed discussion advancing

towards a uniform definition of the older offender.Such a uniform definition would make future research

more comparableand ensure that there is no ambiguity when researchersstate that the study population

is ‘‘olderoffenders’’.

Keywords Mental health, Accelerated aging, Aging prisoners, Older offenders, Older prisoners,

Somatic health

Paper type Research article

Introduction

In Gerontology literature, 65years is the commonly used age cut-off to begin defining an

older person, whereas the United Nation uses 60years as the age cut-off (United Nations,

2015). Within this categorization as an older person, this group is further divided into the

young-old (65-74years), the middle-old (75-84 years) and the oldest-old (85years and

older) (Lee et al.,2018;Alterovitz and Mendelsohn,2013). At a minimal level, consistent age

cut-off allows common understanding on who forms a particular population. At greater

levels, it allows comparative research and formulation of public policy for that age group

and its sub-groups. A uniform definition for “older offenders” is an essential first step to

improve health care for this population (Ahalt et al., 2013) as well as research and policies.

This need has been repeatedly expressedby experts in the field of correctional health care

(Kakoullis et al., 2010;Williamset al., 2012b). However, we still lack agreement as to at what

age a prisoner should be deemed “older”.

The definition of an older offender is usually based on chronological age, using a certain

age cut-off to differentiate between younger and older offenders. In available literature on

older prisoners, the cut-off age varies from 45 to 65 years (Yorston and Taylor, 2006;Aday

and Krabill, 2012;Stojkovic, 2007). An explanation for the discrepancies in age cut-offs

could depend on the data used by the researcher (Uzoaba, 1998). Other common reasons

Helene Merkt,

Sophie Haesen and

Leila Meyer are all based at

the Institute for Biomedical

Ethics, University of Basel,

Basel, Switzerland.

Reto W. Kressig is based at

the University Centre for

Medicine of Aging, Felix

Platter Hospital, Basel,

Switzerland and Faculty of

Medicine, University of

Basel, Basel, Switzerland.

Bernice S. Elger and

Tenzin Wangmo are both

based at the Institute for

Biomedical Ethics,

University of Basel, Basel,

Switzerland.

Received 8 November 2019

Revised 2 January 2020

8 January 2020

Accepted 9 January 2020

Conflict of Interests: The

authors declare that there is no

conflict of interest.

Funding: This work was

supported by the Swiss

National Science Foundation

[grant number 166043].

DOI 10.1108/IJPH-11-2019-0060 VOL. 16 NO. 2 2020, pp. 95-116, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 95

for choosing lower age cut-offs are basedon the assumption that prisoners are subjectedto

premature aging, often called “accelerated aging” (Cipriani et al., 2017). However, the

empirical evidence supporting this theory of “accelerated aging” is unclear (Kakoullis et al.,

2010). Thus, the chosen age cut-offs as well as the provided arguments to support this

choice vary highly, making comparisons of data across studiesdifficult.

This missing shared understanding of the group of older offenders hinders the advancement

of research on the health of older prisoners (Kakoullis et al., 2010) and consequently makes it

difficult to plan health services (Hayes et al.,2012) as well as related issues, such as

programming (Aday, 1994), housing and transition planning (Jang and Canada, 2014). This is

of particular importance given the current rising trend in the numbers of older prisoners. They

are proportionally the fastest growing age group in prison systems around the world (Di Lorito

et al.,2018

;Baidawi and Trotter, 2016;Aday and Krabill, 2012;Skarupski et al., 2018).

Presently, prisoners over the age of 50 years, for instance, make up between 10 per cent of

the prison population in Ireland, 13 per cent in the UK, and 18.8 per cent in the USA and 25

per cent in Italy (Di Lorito et al., 2018). At the same time, they suffer from a greater disease and

disability burden compared to both younger prisoners and older community-dwelling adults

(Fazel et al., 2001,Di Lorito et al., 2018). Consequently, they are a population with high health-

care needs and the main drivers of rising prison health-care costs (Yarnell et a l.,2017).

Specifically, it is estimated that the cost of incarcerating an older prisoner is two to three t imes

that of a younger prisoner within the American correctional system (Maschi et al., 2013). With

the already very limited resources in prison settings, it is therefore important to provide

services that are adequate and cost-effective. To do so, it is necessary to target specific

groups based on their needs. However, the available data on health-care needs of older

prisoners is scarce (Di Lorito et al., 2018) and the integration of the available literature is often

hampered through missing agreements on how to define the older prisoner.

This review aims at providing a much needed overview of the current understandings on

how older offenders are defined by different research groups. It highlights the chosen age

cut-offs, the terminologyused to describe this age group as well as the arguments provided

to support this choice. Specific focus will be given to the literature cited to support each

argument because researchers in the field have raised concern about the empirical

evidence being unclear. In doing so, this paper fills a research gap by answering multiple

calls to advance toward a uniform definition of older offenders.

Methods

This review follows the guidelines of the Preferred Reporting Items for Systematic Reviews

and Meta-Analyses (Moher et al.,2015). The terms prisoner, inmate, offender, detained

person and person deprived of liberty are used interchangeably throughout this article. By

using these terms, we describe people that are detained in correctional facilities, such as

prisons, jails and forensic psychiatricclinics.

Eligibility criteria

The eligibility criteria were defineda priori. We set no time limit for the articles published and

retrieved those published until 31st of January 2018. Opinions, dissertations, books and

book chapters were not included. Empirical peer-reviewed articles, written in English

language, were included and reviewed against three inclusion and three exclusion criteria.

Inclusion criteria were:

1. The studied population was persons deprived of liberty.

2. Older offenders had to either be the main study population or specifically mentioned as

a sub-group.

3. The study had a focus on health and well-being of older offenders.

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