The impact of dementia in the prison setting: A systematic review

Abstract

Older prisoners are the fastest growing group in the prison population, with an accelerated aging process they are at a high risk of developing dementia. However, no systematic review has explored the impact of dementia in the prison setting. The objectives of this review were to identify the prevalence of dementia in the prison setting and how prison, health and social care providers assess, diagnose, treat, support and care for prisoners with dementia. A systematic search of the literature from the following databases was undertaken: CINHAL, PubMed, BNI, PsychINFO, and MEDLINE. Search strategies were tailored for each database and included recognised Medical Subject Headings. Hand searching of prominent journals in correctional services and dementia, as well as reference lists of included papers was completed. Open Grey website was searched to identify relevant government, local council and charity publications regarding dementia in the prison setting. The appropriate Critical Appraisal Skills Programmes Checklist for all included studies was completed. Following the application of inclusion and exclusion criteria, 10 studies were included in the review. Due to the nature of the data extracted, a meta-synthesis was not possible; therefore, a thematic synthesis was completed. Three themes emerged: prevalence of dementia in the prison population, identification of older prisoner’s needs, and knowledge of correctional officers and legal professionals. The prevalence and incidence of dementia in prison populations remain largely unknown. There is a need for national policies and local strategies that support a multi-disciplinary approach to early detection, screening and diagnosis of cognitive impairment and dementia across prison settings. Alongside the development of structured prison environments, non-pharmacological interventions, continued assessment of prisoners with a dynamic care plan, and training for health, social and prison staff and prisoners.