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Japan: This old man with Alzheimer’s disease killed his granddaughter. He says he doesn’t remember

In a court in western Japan last month Susumu Tomizawa, 88, admitted to killing his granddaughter Tomomi, 16, almost two years ago – but, he said, he does not remember doing it .

Tomizawa has Alzheimer’s disease, a progressive and irreversible neurological disease that destroys neurons and shrinks regions of the brain. In court, his lawyers argued that he should not be held criminally responsible because his illness causes dementia, a condition marked by multiple cognitive deficits such as memory loss.

“He was insane at the time due to dementia and alcohol consumption…and therefore pleaded not guilty,” they said.

But the Fukui City Court disagreed.

On May 31, Tomizawa was sentenced to four and a half years in prison for murder.

The case shocked many people in Japan, an aging country where the number of elderly patients with dementia is on the rise.

The trial, broadcast live from the court, was closely watched and drew sympathy from many who expressed pity for Tomizawa and the family’s loss of Tomomi.

Stabbed to death

Tomizawa and Tomomi lived at his home in Fukui City, the court heard.

On the night of September 9, 2020, they had a fight and resulted in the teen’s death.

Tomizawa remembers drinking a lot that night. Upset and inebriated, he took a 17 centimeter (nearly 7 inch) long kitchen knife and entered Tomomi’s room, where he repeatedly stabbed her in the neck, learned the court last month.

The alarm was raised when Tomizawa called his eldest son, saying he had found Tomomi’s bloody body, the court heard. The police arrived at the scene soon after and arrested the old man.

Tomizawa’s mental state was at the center of his trial as doctors, lawyers and judges debated whether or not he knowingly killed his granddaughter.

Doctors who assessed his condition insisted he had a motive to commit murder. “His actions were deliberate and consistent with his intent to kill,” forensic psychiatrist Hiroki Nakagawa told the court.

Prosecutors said the elderly man was able to control his actions and “possessed the ability to judge right and wrong”, despite his illness.

In its decision, the court recognized Tomizawa’s Alzheimer’s disease, but said it understood the weight of his actions. “After careful consideration and consultation with the defendant, we [made] careful judgment,” Judge Yoshinobu Kawamura said.

“The accused was in a state of mental exhaustion at the time of the crime and he had great difficulty in judging right or wrong or in deterring himself from committing the crime – but he was not in a state where he was unable to do so.”

disease of the mind

According to experts, Alzheimer’s disease is the most common form of dementia in the elderly.

“It’s a degenerative brain disease,” said Jason Frizzell, a psychologist who specializes in criminal cases. “In virtually all cases, there is a gradual decline in a person’s abilities over time.”

The disease attacks the brain and memory loss worsens as it progresses. Symptoms like paranoia, agitation, confusion and even violent outbursts are likely to occur, said Frizzell, who is also a professor at Arizona State University.

“Of course, not all patients will be [display] the same set of symptoms. Situational context can also play a role in aggression, whether a patient is afraid of places or people they don’t recognize,” he said.

Alzheimer's disease facts

Jacob Rajesh, senior forensic psychiatrist at Promises Healthcare in Singapore, said that in cases of rapidly progressing Alzheimer’s disease “it will be difficult to provide an accurate account of what actually happened. “.

“There is also the issue of fitness to stand trial – is a person fit enough to testify on the stand and plead guilty or not guilty?” he said.

Crimes involving dementia patients are also extremely complex, experts said.

“How much of their conduct can we reasonably explain by illness itself as opposed to other motivations such as anger or revenge,” Frizzell said. He also emphasized moral and ethical value judgments.

“How can we effectively or reasonably prosecute someone who might be completely debilitated by their disease in a few more years? Does compassion for a convicted person with dementia conflict with the perception of justice by the community?”

“Prisons full of elderly inmates”

Japan has one of the largest elderly populations in the world. More than 20% of its residents are over the age of 65, according to government records, and the number of Japanese centenarians is on the rise.

Dementia mainly affects older people and it is believed that there are more than 4.6 million people in Japan living with the disease. Experts say the number will increase dramatically as the country continues to age rapidly.

Violent crimes committed by Japanese dementia patients are rare, but a case similar to Tomizawa’s in 2014 saw a 72-year-old man with dementia strangle an 82-year-old woman to death in a hospice. He received a reduced prison sentence of three years due to his condition.

A record one in 1,500 people in Japan is at least 100 years old - and that's likely to be a woman

“Japan’s prisons are full of elderly inmates suffering from dementia,” said Koichi Hamai, a criminal justice expert and professor of law at Ryukoku University in Kyoto. “The number of elderly prisoners is increasing and we need to take various measures to [address it].”

Tomomi had lived with her grandfather in Fukui, one of Japan’s least populated prefectures and where about one in three residents are over 65, according to government figures.

Details of their lives were scarce, but observers pointed to issues such as aggression and domestic violence that Alzheimer’s patients and their frustrated caregivers often faced.

“Patients with dementia are known to act against the people who care for them, those closest to them,” said Rajesh, the forensic psychiatrist.

“The patients [like Tomizawa] needed a lot of supervision and management to be home, and it wasn’t immediately obvious that he had any.”

CNN’s Emiko Jozuka and Kathleen Benoza contributed reporting.

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