title: Competence-to-stand-trial evaluations of geriatric defendants.
abstract: This descriptive study compares geriatric defendants (n = 57) found competent to stand trial (n = 36) with those found incompetent (n = 21). A review of the records of 57 consecutive pretrial geriatric detainees who underwent competence-to-stand-trial evaluation was conducted. The review included comparison of demographic and historical variables, mental status examination (MSE) elements, and trial abilities. Incompetent subjects were older and more frequently had dementia, but did not necessarily have other psychiatric illnesses. Deficits in orientation, memory, abstraction, concentration, calculation, and thought process were associated with incompetence. Deficits in orientation and memory correlated most highly with incompetence. Trial-related deficits associated with incompetence included failure to understand Miranda warnings, legal charges, potential penalties, roles of court officers, pleas, and plea-bargaining and inability to consult with an attorney and be self-protective. The ability to maintain appropriate courtroom behavior was not different between groups. The inability to consult with an attorney and understand Miranda was most predictive of incompetence-to-stand-trial opinions.
authors.affiliation: Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia 29202, USA. rlf51@wshpi.dmh.state.sc.us
authors.forename: Richard L
authors.initials: RL
authors.lastname: Frierson
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Shea
authors.forename: Mary E Craig
authors.initials: ME
authors.lastname: Shea
mesh_terms: D000368:Aged; D000369:Aged, 80 and over / Q000523:psychology; D003416:Criminal Law; D003704:Dementia / Q000523:psychology; D005163:Factor Analysis, Statistical; D005555:Forensic Psychiatry; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D016743:Mental Competency / Q000145:classification / Q000331:legislation & jurisprudence* / Q000523:psychology; D001523:Mental Disorders / Q000145:classification / Q000453:epidemiology*; D008606:Mental Processes; D011157:Population Dynamics; D013022:South Carolina / Q000453:epidemiology