Wandering behaviour in community-residing persons with dementia.
OBJECTIVE
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.


METHODS
Cross-sectional, case-control investigation.


METHODS
University-affiliated outpatient neuropsychiatric assessment center.


METHODS
Six hundred and thirty-eight consecutive community-residing new patients with dementia referred for evaluation.


METHODS
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.
Klein
D A
DA
Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
Steinberg
M
M
Galik
E
E
Steele
C
C
Sheppard
J M
JM
Warren
A
A
Rosenblatt
A
A
Lyketsos
C G
CG
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000150:complications; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011595:Psychomotor Agitation / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000150:complications; D014481:United States / Q000453:epidemiology
D014150:Antipsychotic Agents