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Getting lost in dementia: a longitudinal study of a behavioral symptom
R McShane1, K Gedling, J Keene
1Section of Old Age Psychiatry, Warneford Hospital, Oxford, United Kingdom. rupert.mcshane@psych.ox.ac.uk
International Psychogeriatrics
|October 24, 1998
Summary
Wandering in dementia patients is common, often necessitating caregiver intervention and institutionalization. Better topographical memory may predict a lower risk of getting lost.
Area of Science:
- Gerontology
- Neurology
- Psychiatry
Background:
- Wandering and getting lost are significant challenges for individuals with dementia living at home.
- Caregiver burden and patient safety are major concerns associated with this behavior.
Purpose of the Study:
- To investigate the incidence and predictors of getting lost in a cohort of dementia patients over five years.
- To determine the association between getting lost and institutionalization.
- To explore the utility of topographical memory assessment in predicting wandering behavior.
Main Methods:
- Longitudinal study of 104 dementia patients living at home with caregivers.
- Regular assessments every four months over a five-year period.
- Evaluation of topographical memory using a behavioral test.
Main Results:
- 43% of subjects required retrieval at least once; 5% repeatedly got lost.
- Getting lost was significantly associated with increased likelihood of institutionalization (OR=7.3).
- Higher performance on topographical memory tests predicted a lower risk of getting lost (NPV=90%).
Conclusions:
- The risk of dementia patients getting lost is substantial, posing a major reason for institutionalization.
- Frequent caregiver intervention is often required.
- A simple topographical memory test could aid in assessing and managing the risk of wandering in dementia.