Past incarceration may raise the risk of cognitive impairment, mental health conditions, and heavy drinking in older people, a study published today in JAMA Network Open suggests.
Ilana R. Garcia-Grossman, M.D., of the University of California, San Francisco, and colleagues analyzed data from 13,462 community-dwelling adults aged 50 years or older who participated in the Health and Retirement Study (HRS) in 2012 or 2014. The HRS is a longitudinal survey of adults in which participants are asked about their economic, health, and psychosocial well-being. The participants were considered to have mental health conditions if they had been told by a physician that they have any emotional, nervous, or psychiatric problem. The participants were considered to have cognitive impairment if they had been told by a physician that they have Alzheimer disease, dementia, senility, or serious memory impairment. Garcia-Grossman and colleagues defined self-reported heavy alcohol use as drinking more than four alcoholic drinks daily.
Among the 13,462 participants, 946 (7.6%) reported having been incarcerated at some point in their lives. Those who had been incarcerated had a mean age of 62.4 years versus 66.7 years for those who had not been incarcerated and were more likely to be male, Black, or Latinx or in the lowest quartile of wealth (total assets and debts).
After adjusting for the participants’ age, sex, race and ethnicity, wealth, educational attainment, and uninsured status, the researchers found that those who had been incarcerated had an 80% higher risk of having cognitive impairment or a mental health condition and a 113% higher risk of heavy alcohol use than participants who had not been incarcerated. Participants who had been incarcerated also had a higher risk of having hearing impairment, chronic lung impairment, mobility impairment (for example, using a cane or walker), and impairment in activities of daily living (for example, difficulties taking medications and shopping for groceries).
“It is possible that people who experience incarceration have worse baseline health before they enter jail or prison that persists into older age following incarceration,” Garcia-Grossman and colleagues wrote. “Additionally, exposure to incarceration may exacerbate poor health outcomes through exposure to trauma and violence, acute and chronic stress from living in dehumanizing conditions, and/or variable access to healthy food, physical activity, and high-quality health care.”
The researchers added that it is also possible that incarceration has a negative impact on social determinants of health such as employment or housing.
“These findings suggest that attention to incarceration history may be valuable for understanding and mitigating health risks in older age,” the researchers concluded.
For related information, see the Psychiatric Services article “Mental Health in the Era of Mass Incarceration.”
(Image: iStock/tiero)
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