The Hitman’s Myth: Why ‘Memory of a Killer’ Gets Alzheimer’s Wrong

The Hitman’s Myth: Why ‘Memory of a Killer’ Gets Alzheimer’s Wrong

By Monisha Chandrashekar, M.A. | Reviewed by Dana R. Anderson, Psy.D.

A television premise can make memory loss look neat, dramatic, and strangely selective. A hitman forgets the murders, but not the rest of his life. It is a gripping idea from a plot perspective, but it is also not how dementia usually works.

Dementia and Criminal Responsibility

A recent A&E Crime + Investigation article, featuring expert commentary from Dr. Dana Anderson and neurologist Dr. Keith Vossel, used the TV show Memory of a Killer as a launch pad to discuss a more serious question: can a neurodegenerative disease affect criminal responsibility? The answer is more nuanced than television allows. Dementia can alter judgment, behavior, impulse control, and memory, but it does not typically create a tidy, crime-specific blackout. In real-world cases, cognitive decline is broader, messier, and clinically recognizable across settings, not just around an alleged offense. That distinction matters.

Memory and Intent in Forensic Evaluations

In both clinical and legal settings, memory and intent are not the same thing. A person may have limited recall of an event afterward, yet still have understood what they were doing at the time. From a forensic standpoint, the question is not simply, “Do they remember it now?” but “What was their mental state when it happened?” That is why courts do not rely on self-reported forgetfulness alone. They look at medical records, collateral information, neuropsychological data, and psychometric testing.

What the Research Actually Shows

Recent research reinforces why that careful approach is necessary. In a 2025 study examining 62 offenders with dementia in Australian courts, most cases involved violent offenses such as homicide, assault, or sexual offending. Importantly, the authors found that offending was often associated with executive dysfunction: a severe difficulty in managing thoughts, emotions, and behavior, especially in conditions such as frontotemporal dementia, subcortical vascular dementia, Huntington’s disease, and substance-related dementias. Alzheimer’s disease, by contrast, was comparatively underrepresented in the offender sample, and the study notes that early Alzheimer’s is more strongly characterized by memory disturbance than the kind of disinhibition that more often drives serious offending (Reutens et al., 2025).

Another 2024 study found a similar pattern. Risky or potentially illegal behavior was far more common in certain types of dementia than in Alzheimer’s disease. It appeared in about two-thirds of people with behavioral-variant frontotemporal dementia, nearly half of those with right-sided semantic dementia, and about one-quarter of those with Alzheimer’s disease. In about 1 out of 5 cases, those behaviors led to contact with police or other authority figures. Compared with healthy older adults, people with dementia were also more likely to show physical aggression or reckless behavior involving money or work. These findings suggest that when troubling new behavior starts later in life, it may point more toward frontotemporal dementia than Alzheimer’s disease (Kumfor et al., 2024).

Why Fictional Portrayals Don’t Reflect Real Cognitive Decline

It is not that Alzheimer’s disease is irrelevant in forensic cases. Nevertheless, as dementia progresses, certain individuals might show apathy, irritability, emotional blunting, poor judgment, reduced inhibition, or confusion about context. Those changes can matter legally, especially where the alleged behavior was impulsive, reactive, or linked to impaired understanding. But the research does suggest that when dramatic criminal behavior emerges, particularly with disinhibition, poor social judgment, or reactive aggression, clinicians should think carefully about whether a dementia involving frontal brain systems is a better fit than a simple “Alzheimer’s related memory loss” narrative (Reutens et al., 2025; Kumfor et al., 2024).

This is one reason fictional portrayals can mislead. Complex, organized crimes require planning, sequencing, and sustained cognitive control, all of which tend to erode as dementia advances. In the Australian court study, the authors noted that offending in frontotemporal dementia was often reactive rather than planned, and that serious crimes such as murder were rare in the broader literature, particularly in Alzheimer’s disease (Reutens et al., 2025).

The Task of Forensic Assessment

The real forensic task, then, is not to romanticize Alzheimer’s or dismiss it. It is to evaluate it carefully. When memory complaints, behavioral change, and criminal allegations intersect, the central issue is whether there is credible evidence of neurocognitive impairment, what type of impairment is present, and how that impairment relates to judgment, intent, and functional capacity at the time of the alleged act. That is where rigorous forensic assessment matters most.

References

Kumfor, F., Wei, G., Ries, N., Bennett, H., D’Mello, M., Kaizik, C., Piguet, O., & Hodges, J. R. (2024). Examining the propensity and nature of criminal risk behaviours in frontotemporal dementia syndromes and Alzheimer’s disease. Alzheimer’s & Dementia : Diagnosis, Assessment & Disease Monitoring, 16(2), e12577. https://doi.org/10.1002/dad2.12577

Reutens, S., Butler, T., Hwang, Y. I. J., & Withall, A. (2025). An examination of criminal offenders with dementia in Australian courts. Psychiatry, Psychology and Law, 32(1), 92–105. https://doi.org/10.1080/13218719.2023.2280518

Crawford, R. P. (2026, February 12). “Memory of a Killer” Explores Alzheimer’s Connection to Killing—How it Actually Affects the Brain. https://www.aetv.com/articles/memory-of-a-killer-alzheimer’s-connection-how-it-affects-brain