Wandering behaviour in community-residing persons with dementia

Objectives. To examine wandering behaviour in elderly demented persons in t he community setting with respect to dementia characteristics and other fac tors that might influence wandering behaviour; to generate a statistical mo del to assess the relative importance of these various factors in predictin g wandering behaviour. Design. Cross-sectional, case-control investigation. Setting. University-affiliated outpatient neuropsychiatric assessment cente r. Participants. Six hundred and thirty-eight consecutive community-residing n ew patients with dementia referred for evaluation. Measurements. Comprehensive neuropsychiatric evaluation, including rating w ith Mini-Mental state Examination; General Medical Health Rating; Comell Sc ale of Depression in Dementia and caregiver interview. Results. Wandering behaviour occurred in 17.4% of participants. It was sign ificantly 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, delu sions, hallucinations, and sleep disorder. Other significant associations o f wandering behaviour included use of neuroleptic medication and male gende r, After statistical adjustment for other variables, duration of dementia, severity of dementia and presence of sleep disorder retained significant st atistical 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 subje ct to modification. It is possible that management of coexistent psychopath ology, particularly of sleep disorder, and of the underlying disease proces s of AD would help to ameliorate this problematic behavioural disorder. Fur ther investigation is warranted into the relationship between neuroleptic m edication and wandering behaviour and into possible alternative measures to control agitation in elderly dementia patients. Copyright (C) 1999 John Wi ley & Sons, Ltd.