The Prevalence of Cognitive Impairment and Dementia in Incarcerated Older Adults

Jacques Baillargeon, Lannette C. Linthicum, Owen J. Murray, Mukaila A. Raji, Yong Fang Kuo, John S. Pulvino, Sadaf A. Milani, Brie Williams, Gwen R. Baillargeon, Patricia A. Blair, M. Kristen Peek, Joseph V. Penn

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: In view of the growing number of older incarcerated persons in the United States, cognitive impairment represents one of the most challenging and costly health care issues facing the U.S. correctional system. This study examined the prevalence and correlates of this growing public health issue in the nation's largest prison system. METHODS: In this study of a random sample of 143 older (≥55 years) adults incarcerated in the Texas prison system, we assessed-using the Montreal Cognitive Assessment (MoCA)-the percentage of inmates who met the MoCA thresholds for mild cognitive impairment (MCI; <23) and dementia (<18). Due to sample size limitations, our multivariable analysis assessed the binary outcome, MoCA <23. RESULTS: Overall, 35.0% of our random sample of incarcerated older adults in Texas met the threshold for MCI and 9.1% met the threshold for dementia. After adjusting for covariates, study participants who were Black (odds ratio [OR] = 4.12, 95% confidence interval [CI] = 1.57-10.82), Hispanic (OR = 4.34, 95% CI = 1.46-12.93), and those with a diagnosis of major depressive disorder (8.56, 95% CI = 1.21-60.72) all had higher prevalence of a positive screen for MCI or dementia. Dementia was underdiagnosed in our study sample of incarcerated adults, with 15.4% of MoCA-diagnosed dementia patients having a dementia diagnosis documented in their medical records. DISCUSSION: Future studies of cognitive impairment in prisons and jails can inform health care planning and resource allocation, such as expansion of access to palliative care, advance care planning, and targeted cognitive screening in older age groups.

Original languageEnglish (US)
Pages (from-to)2141-2146
Number of pages6
JournalThe journals of gerontology. Series B, Psychological sciences and social sciences
Issue number12
StatePublished - Dec 6 2023


  • Dementia
  • Mild cognitive impairment
  • Prison

ASJC Scopus subject areas

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies


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