Behavioral dimensions of patients at risk of wandering

Dawson, Peg; Reid, DW

doi:10.1097/00002093-198701040-00040

Cited by 7 publications

(11 citation statements)

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“…However, our previous work indicates that nurses, who have a similar level of exposure to persons with dementia as do family caregivers, could reliably classify subjects using the same item as we employed with family caregivers in this study [11]. Further, using caregivers to identify wanderers has been a common approach of other investigators [5,7,24].…”

Section: Discussionmentioning

confidence: 88%

The Interrelatedness of Wandering and Wayfinding in a Community Sample of Persons with Dementia

Algase

Son

Beattie

et al. 2004

Dement Geriatr Cogn Disord

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The aim of this study was to evaluate the relationship of wandering and wayfinding and validate the Revised Algase Wandering Scale – Community Version (RAWS-CV) using a community sample of persons with dementia. Adult caregivers (n = 266) completed the RAWS-CV and the Wayfinding Effectiveness Scale (WES). Four aspects of wandering were confirmed (persistent walking, repetitive walking, spatial disorientation, eloping behavior), and two new aspects were also validated (negative outcomes, mealtime impulsivity). The spatial disorientation subscale of the RAWS-CV had significant (p < 0.01) negative correlations with all WES subscales. The global strategies and simple wayfinding goals subscales of the WES correlated significantly with all RAWS-CV subscales except repetitive walking and mealtime impulsivity. ANOVAs comparing wayfinding at 4 levels of wandering revealed differences only for the simple wayfinding goals subscale. Studies examining the relationship of wandering and wayfinding at various levels of cognitive impairment are suggested to further understand these phenomena.

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Section: Discussionmentioning

confidence: 88%

The Interrelatedness of Wandering and Wayfinding in a Community Sample of Persons with Dementia

Algase

Son

Beattie

et al. 2004

Dement Geriatr Cogn Disord

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“…Wanderers are distinguishable from non-wanderers by constant disorientation, inability to know when lost, better social skills, and are more active [17]. These traits have serious consequences when the patient wanders into a wilderness or rural location.…”

Section: Introductionmentioning

confidence: 99%

“…Other studies have made estimates of the prevalence of wanderers ranging from twelve to thirty-nine percent [14,15]. Another study reported twenty-six percent of AD patients getting lost in the outdoors in the preceding week [16].Wanderers are distinguishable from non-wanderers by constant disorientation, inability to know when lost, better social skills, and are more active [17]. These traits have serious consequences when the patient wanders into a wilderness or rural location.…”

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confidence: 99%

Behavioral profile of possible Alzheimer's disease patients in Virginia search and rescue incidents

Koester¹,

Stooksbury²

1995

Wilderness & Environmental Medicine

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We performed a retrospective study of the behavior of lost Dementia of Alzheimer's Type (DAT) patients who became the subjects of organized Search and Rescue efforts. We compared the DAT patients behavior to the behavior of elderly lost victims that possessed normal cognitive abilities. Data for both populations was from the Virginia Department of Emergency Services lost subject database. We found that normal elderly individuals on average traveled a greater straight line distance (2.56 km) from the Point Last Seen (PLS) than DAT patients (0.88 km). The median straight line distance from the PLS was the same for both populations (0.8 km). The mortality rate for DAT patients was 19 percent. Mortality was caused by hypothermia, dehydration, and drowning. No fatalities were found among DAT patients when they were located within 24 hours. A mortality rate of 46 percent was found for patients requiring more than 24 hours to locate. This 24 hour survivability window suggests that lost DAT patients require an immediate and aggressive search response.Keywords: Wandering, Alzheimer's Disease, Lost person behavior, missing person, Behavioral profile IntroductionOur goals are to create a preliminary behavioral profile of lost Dementia of Alzheimer's Type (DAT) patients, determine factors that impact survivability, and to create a database. Incident commanders in missing person searches rely on lost person behavior profiles and statistics for the initial deployment of resources, development of objectives, and predicting survivability. The major textbooks and field guides currently used by incident commanders combine both Alzheimer's with Elderly subjects or fail to give any numbers [1,2]. Unfortunately, search subjects suffering from Alzheimer's disease are grouped with elderly subjects or undocumented.Current estimates of Alzheimer's Disease are four million based upon an estimated 10.3% of the population over the age of 65 suffers from probable Alzheimer's disease [3]. An estimated 12-14 million Americans will be affected by the year 2040 [4]. The increase is believed to be due to an increase in awareness of the disease and an increase in the age of the U.S. population [5]. Regional demographics also will affect the percentage of Alzheimer's cases found in each state. Indeed there appears to be a higher prevalence in rural areas [6] and among those with less education [7,8]. It is this particular subset of DAT patients that often results in search and rescue incidents.Alzheimer's disease (AD) is a disease of exclusion since only after the patients' death can it be diagnosed positively. However, DAT [9] or probable AD is characterized well and can be documented with behavioral tests [10,11,12]. Wandering significantly increases with further deterioration of the DAT patient. Among mild cases of DAT, 18% of the patients wander, while in severe cases, wandering increases to 50% [13]. Other studies have made estimates of the prevalence of wanderers ranging from twelve to thirty-nine percent [14,15]. Another study reported twe...

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“…Several authors have demonstrated a relationship between wandering and severity of cognitive impairment (Cooper et al, 1990;Burns et al, 1990;Teri et al, 1988;Cooper and Mungas, 1993;Algase, 1992;Hope et al, 1997). Wandering has been associated with parietal lobe dysfunction (de Leon et al, 1984;Henderson et al, 1989), graphomotor perseveration (Ryan et al, 1995), and with other behavioural disorders that aict dementia patients (Dawson and Reid, 1987;Cohen-Mans®eld, 1986). In addition, nighttime wandering or pacing among elderly demented persons has been linked to circadian dysregulation (Okawa et al, 1991;Satlin et al, 1991).…”

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confidence: 99%

Wandering behaviour in community-residing persons with dementia

Klein

Steinberg

Galik³

et al. 1999

Int. J. Geriat. Psychiatry

119

116

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Objectives To examine wandering behaviour in elderly demented persons in the community setting with respect to dementia characteristics and other factors that might influence wandering behaviour; to generate a statistical model to assess the relative importance of these various factors in predicting wandering behaviour. Design Cross‐sectional, case‐control investigation. Setting University‐affiliated outpatient neuropsychiatric assessment center. Participants Six hundred and thirty‐eight consecutive community‐residing new patients with dementia referred for evaluation. Measurements Comprehensive neuropsychiatric evaluation, including rating with Mini‐Mental State Examination; General Medical Health Rating; Comell Scale of Depression in Dementia and caregiver interview. Results Wandering behaviour occurred in 17.4% of participants. It was significantly more prevalent in patients with Alzheimer Dementia (AD), patients with dementia of longer duration, and patients with more severe dementia. Wandering behaviour was associated with moderate to severe depression, delusions, hallucinations, and sleep disorder. Other significant associations of wandering behaviour included use of neuroleptic medication and male gender. After statistical adjustment for other variables, duration of dementia, severity of dementia and presence of sleep disorder retained significant statistical association with wandering behaviour. Conclusions Wandering behaviour among community‐residing elderly dementia patients is associated with a number of factors, some of which may be subject to modification. It is possible that management of coexistent psychopathology, particularly of sleep disorder, and of the underlying disease process of AD would help to ameliorate this problematic behavioural disorder. Further investigation is warranted into the relationship between neuroleptic medication and wandering behaviour and into possible alternative measures to control agitation in elderly dementia patients. Copyright © 1999 John Wiley & Sons, Ltd.

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Behavioral dimensions of patients at risk of wandering

Cited by 7 publications

References 0 publications

The Interrelatedness of Wandering and Wayfinding in a Community Sample of Persons with Dementia

The Interrelatedness of Wandering and Wayfinding in a Community Sample of Persons with Dementia

Behavioral profile of possible Alzheimer's disease patients in Virginia search and rescue incidents

Wandering behaviour in community-residing persons with dementia

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