title: Dementia, walking outdoors and getting lost: incidence, risk factors and consequences from dementia-related police missing-person reports.
abstract: OBJECTIVE
  To estimate incidence, identify consequences and potential risk factors for harm in people with dementia who got lost in one UK policing region.
  
  
  METHODS
  In a retrospective observational study, data were extracted from missing-person records over a four-year period in one UK policing region (population of 2.1 million).
  
  
  RESULTS
  Two hundred and eighty-one incidents of getting lost were identified. Incidence of getting lost was estimated at 0.5% of the regional dementia population. Fifty-nine percent of reports came from domestic settings, 29% from care homes/hospitals, and 12% on excursions from home. Five percent (n = 15) sustained significant harm, including two deaths. Average age was 78 years (SD 8.3). Harm was associated with older age (mean difference 6.16 years, CI 1.86 to 10.46, p = 0.005, t = 2.82), length of time missing (Mdn time 2.48 hours; IQR 0.97 to 9.45, p = 0.02), and season (9% winter, 2% summer, p = 0.006). The length of time missing increased with delays in reporting to police (r = 0.15, p = 0.018), getting lost at night (Mdn time 1.70 hours, IQR 0.52-3.32, p = 0.028), driving themselves (Mdn time 2.45 hours, IQR 0.42-2.00, p = 0.001), and using public transport (Mdn 1.78 hours, IQR 1.07-3.92, p = 0.001).
  
  
  CONCLUSIONS
  Incidence in this study suggests getting lost is a low-frequency event for people with dementia but for a small minority, the risks are considerable. Exploratory analyses suggest individual and environmental factors increase the risk of harm. Suitable methods need to be developed to replicate these findings in larger prospective samples. A focus on the predictors of harm may aid development of assessment protocols to ensure intervention is proportionate.
authors.affiliation: a School of Applied Social Studies , University College Cork , Cork , Ireland.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Bantry White
authors.forename: Paul
authors.initials: P
authors.lastname: Montgomery
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016495:Police / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D016138:Walking
keywords: challenging behaviour; dementia and cognitive disorders; psychological and behavioural symptoms