Wandering Dementia-A Syndrome with Forensic Implications

Wandering behavior in dementia may result in significant injury or death. Search of files at Forensic Science South Australia over a 20-year period (1998-2018) identified nine individuals with dementia who were found deceased having been reported as missing from home/residential facilities (M:F, 6:3; age range, 54-92 years; average, 77.7 years; median, 80 years). The established clinical diagnoses were of dementia in seven cases and Alzheimer disease in two. Deaths were unnatural in six cases: hypo/hyperthermia three, drowning two, train impact one; natural in two cases due to ischemic (N=1) and valvular heart disease (N=1); and undetermined in one case due to marked decomposition. There were five fatalities in winter. Exposure and drowning were significant causes of death. The increasing aging population means cases of lethal wandering dementia will be more often encountered among forensic cases in future. Issues around duty of care and suicide should be considered in evaluating cases.