OBJECTIVE Competency to stand trial (CST) is foundational to the U.S. criminal legal system. Dementia is increasingly prevalent in the United States, and older adults are becoming involved with the U.S. criminal legal system at unprecedented rates, which carries significant implications for legal professionals and clinicians involved in CST cases. Unfortunately, CST research to date has largely excluded considerations of dementia and aging. The present study addressed this gap by reviewing U.S. case law related to dementia and CST. HYPOTHESES The present study had no hypotheses because of its descriptive nature. METHOD This was a case law review of 118 U.S. court cases involving dementia and CST from 2002 through 2022. Relevant information was coded about the legal case, defendant demographics, clinical evaluation(s), and court determination. RESULTS Competency was mostly raised by the defense (81%). Similar percentages of defendants were involved in one, two, and three or more evaluations, mostly conducted by experts appointed by courts or retained by the defense. Trends for court determinations were based on the number of evaluations conducted and experts' (dis)agreement about diagnosis and CST recommendation. Ultimately, 45% of defendants were determined incompetent, with trends appearing for dementia diagnosis, cognitive deficits, index offense, and jurisdiction, but not age. Ability to assist was the most cited reason for determinations of incompetence, often in combination with both factual and rational understanding or one of these psycholegal abilities alone. CONCLUSIONS Dementia and related impairments appear especially relevant to CST among older adults and carry important implications for clinicians, legal professionals, and policymakers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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痴呆症和在美国接受审判的能力：判例法审查。


目标 受审能力 (CST) 是美国刑事法律体系的基础。痴呆症在美国越来越普遍，老年人正以前所未有的速度参与美国刑事法律体系，这对参与 CST 案件的法律专业人员和临床医生产生了重大影响。不幸的是，迄今为止，CST 研究很大程度上排除了对痴呆和衰老的考虑。本研究通过回顾美国与痴呆症和 CST 相关的判例法来解决这一差距。假设本研究由于其描述性性质而没有假设。方法 这是对 2002 年至 2022 年 118 起涉及痴呆症和 CST 的美国法院案件的判例法审查。对法律案件、被告人口统计、临床评估和法院判决的相关信息进行了编码。结果 能力主要由防守方提高（81%）。参与一项、两项、三项或以上评估的被告比例相似，大部分由法院指定或辩方聘请的专家进行。法院裁决的趋势基于进行的评估数量以及专家对诊断和 CST 建议的同意（不同意）。最终，45% 的被告被判定为无行为能力，痴呆症诊断、认知缺陷、犯罪指数和管辖权都出现了趋势，但年龄却没有。协助能力是判定无能力的最常引用的原因，通常与事实和理性理解相结合，或单独与这些法律心理能力之一相结合。结论 痴呆症和相关损伤似乎与老年人的 CST 特别相关，并对临床医生、法律专业人员和政策制定者产生重要影响。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。