Wandering in dementia: a longitudinal study.
OBJECTIVE
This article analyzes the natural history of wandering behavior throughout the course of dementia.


METHODS
Prospective, 10-year, longitudinal study of wandering behavior in dementia, with autopsy follow-up.


METHODS
Participants with dementia, living at home with a carer. All lived in Oxfordshire, UK.


METHODS
Eighty-six people with dementia who were living at home with a carer and who were able to walk unaided at entry to study.


METHODS
At 4-monthly intervals, the carers were interviewed using the Present Behavioural Examination to assess wandering behavior in detail; participants with dementia were assessed cognitively. Nine types of "wandering" behavior were distinguished.


RESULTS
Changes in wandering behavior were not generally related to gender, age, or time since onset of dementia. Onset of different types of wandering behavior showed some relationship with cognitive state. Various forms of increased walking first appeared during moderate dementia, each type typically persisting for 1 to 2 years. Late dementia was characterized by decreased walking and immobility.


CONCLUSIONS
Wandering behavior in dementia can cause great problems for carers. There are different causes for such changes, some of which are related to cognitive ability, for example increased confusion results in ineffectual "pottering" and getting lost. Increased walking at night corresponds with disruption of diurnal rhythm.
Hope
T
T
Department of Psychiatry, University of Oxford, Warneford Hospital, UK.
Keene
J
J
McShane
R H
RH
Fairburn
C G
CG
Gedling
K
K
Jacoby
R
R
D000204:Activity Cycles; D000368:Aged; D000369:Aged, 80 and over; D001923:Brain Chemistry; D017028:Caregivers / Q000523:psychology; D003071:Cognition; D003704:Dementia / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006948:Hyperkinesis; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D016138:Walking / Q000523:psychology*