**4. Community and correctional settings**

However, these plans and policies concentrate on the general community and do not translate

Australia has developed the 'Corrections Ageing Prisoner and Offender Policy Framework 2015-20', which identifies that ageing prisoners have varying individual and system needs, and these needs should both be considered [24]. There are four fundamental principles characterised: supporting age-appropriate regimens and accommodation, enhancing health and wellbeing, tailored age and interest-relevant programs and building strong partnerships [24]. Situated under these principles there are four key priority areas. The first requires support for staff to ensure they are delivering evidence-based best practice within the facility as well as system enhancement. Secondly, prisoners require access to age appropriate services for their health and well-being. The third priority is about building staff capacity to ensure the workforce is assessing and supporting common ageing conditions. Finally, the fourth provision requires of monitoring of ageing demographics to ensure all prisoners and staff needs are

Overall, the populations of Western countries are ageing, and it has been suggested new technologies in forensic science, changes in prosecution and sentencing laws, alongside reduced options for early release, have contributed to the growth of the older prisoner population [6, 7]. Australian population statistics show the numbers of Australians aged 50 years and over increased by 36.8% in the period 2000–2010 [25, 26]. However, there was an increase of 70.4% in prisoners aged 50–54 years, 79.7% in prisoners aged 55–59 years, 81.8% in prisoners aged 60–64 years and 141.7% increase for the over 65 year old group from the year 2000 to 2012 [26]. This increase in the number of older prisoners has been identified across the world [27]. Accompanying this there is an expected rise in the rate of chronic disease including cognitive

impairment and dementia in correlation to the rise in the general population [25, 28].

in high income countries this rises to about 50% being diagnosed [29].

The World Alzheimer Report 2016 [29] identified in 2016 that there were approximately 46.8 million people across the world with dementia and this is expected to increase by the year 2050 to 131.5 million people. Alzheimer's Disease International [29] recognised that different income level countries have different levels of identification of dementia. For example in low and middle income countries there are only 10% of people with diagnosed dementia, whereas

Approximately 13% of the general US population aged over 65 years have dementia whereas in the prisoner population it can be as high as 44% [30]. Baldwin and Leete [31] reported that a UK survey of prison inmates provided evidence that 15% of those surveyed exhibited signs of cognitive impairment. This was then used as an indication that there could be many unrecognised instances of dementia in prisons [31]. Correctional settings have not been prepared to address the needs of older, infirm or disabled prisoners which create a strain on staff [31]. For instance, it is now recognised that correctional services staff are not trained to identify

into the correctional setting or provide any plans for moving into this environment.

being addressed in a timely manner [24].

122 Cognitive Disorders

**3. Demographics/epidemiology**
