Dementia and the aging population: cognitive screening within correctional health

• DOI: https://doi.org/10.1108/IJPH-08-2021-0070
• Published date: 29 June 2022
• Date: 29 June 2022
• Pages: 63-76
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Lance Washington

Dementia and the aging population:

cognitive screening within

correctional health

Lance Washington

Abstract

Purpose –The purpose of this study was to examine the literature surrounding dementia in the aging

correctional population andassess the role of cognitive screening related to dementia detection within

corrections. The literature regarding the role of dementia within the justice continuum is scant.

Furthermore, correctional health researchers have not reached a consensus on the best age to

administer cognitive screening in older persons or prioritizes a screening tool for the early detection of

dementia.

Design/methodology/approach –A key search term list including dementia screening and was

developed to reviewthe literature surrounding dementia and the agingcorrectional population. PubMed,

Criminal JusticeAbstracts (Ebsco) and the National CriminalJustice Reference Service wereused within

the academic search.A gray literature search using these samesearch terms was conducted reviewing

criminal justicefederal agencies and organizationsfor additional information on the dementiaexperience

within correctional settings. Snowballing was used to capture relevant theoretical and empirical

knowledge.

Findings –Shortages in aging specialized health-care staffing presents a barrier for the clinical

interpretation of MontrealCognitive Assessment (MoCA) results. Correctionalofficers are also identified

as useful candidateswithin the administration of cognitivescreening with proper training. The MoCAmay

be the optimal cognitivescreening tool for dementia, until an original cognitivescreening tool is created

specific to the correctionalpopulation. An age of 55 years or older may serveas the best cutoff score for

classifying incarcerated individuals as older persons, and screening should be prioritized for these

individuals. Finally, new specialized programs related to dementia within correctional settings are

identified.

Research limitations/implications –A limitation of this research is the conflicting opinions among

researchersregarding the use of general cognitive screeningtools within the correctional setting.

Originality/value –This research can informcorrectional organizational policy andpractices regarding

the screening of older persons suspected of dementia. Most notably, this research proposes that

correctionalsettings should incorporatethe MoCA within initial screeningof all individuals 55 years of age

or older, enrichingthe job design of correctional officer’s job positionsto include cognitive testing,and for

correctional settings to provide dementia and age-associated training for correctional officers. Finally,

this paper informs future research in the development of a cognitive assessment tool specific to the

correctionalpopulation.

Keywords Dementia, Alzheimer’s disease, Correctional health care, Jail, Prison, Screening, MoCA

Paper type General review

Introduction

Aging health scholars and practitioners are presently servicing an expeditiously aging

global population. In 2020, the global population of individuals aged 65 or over was

estimated to be 962 million people. This number has at least doubled since 1980 when the

global projection for older persons was only 382 million people (United Nations, 2020). The

Lance Washington is based

at the Department of

Research and Consulting,

National Association of

State Mental Health

Program Directors

Research Institute, Falls

Church, Virginia, USA.

Received 1 August 2021

Revised 16 April 2022

Accepted 10 June 2022

DOI 10.1108/IJPH-08-2021-0070 VOL. 19 NO. 1 2023, pp. 63-76, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 63