Alzheimer's and Wandering, Sometimes Deadly

Sept. 6, 2001 -- For a person with Alzheimer's, getting lost can be deadly.

Last month, for instance, a 75-year-old man who suffered from Alzheimer's disease drowned in Lake Michigan one day after he had been reported missing by family members, The Chicago Tribune reported. He had walked a distance of more than 9 miles from his home.

But this Chicagoan is not alone. Sixty percent, nearly 2 and a half million, of the estimated 4 million Americans with Alzheimer's become disoriented and get lost at some point during the course of their illness, according to Chicago-based Alzheimer's Association.

And if they are not found within the first 24 hours, anywhere from one-third to one-half may die, according to Gerald Flaherty, director of Special Projects at the Massachusetts chapter of Alzheimer's Association. He estimates that hundreds lose their lives every year due to "wandering," succumbing to dehydration, exposure to heat or cold and sometimes drowning.

"That number is likely to be higher," adds Flaherty. "A lot of incidents are not reported because the person has not been diagnosed."

Disorientation to time and place is a main reason why Alzheimer's sufferers wander. Once familiar streets and houses become unfamiliar to Alzheimer's sufferers who can get lost on their own block, steps away from their own home.

"Wandering behavior is not well understood," says Dr. Constantine Lyketsos, professor of psychiatry and director of neuropsychiatry at Johns Hopkins University in Baltimore. "It is associated with more advanced [stages of disease] and it is linked to Alzheimer's disease."

Furthermore, some Alzheimer's sufferers never wander, while others wander repeatedly, and the behavior is difficult to predict.

It can take place in the early stages, before a diagnosis and in other dementia-type diseases.

While most patients will wander on foot, 44 percent of people with Alzheimer's disease commonly get lost while behind the wheel of a car. Forty percent of those with Alzheimer's who drive are involved in crashes, according to a study published in the Journal of the American Geriatric Society in 1988.

Risks of Wandering

Finding the Alzheimer's sufferer can pose challenges for caregivers and for law enforcement.

"A wandering person may experience a catastrophic reaction," says Flaherty. "They will hide or crawl into places that unless the search team is trained to look in, they'll miss."

A patient who wanders can be at risk of dehydration, drowning, exposure to extreme heat or cold if improperly dressed, and rarely, victimization by criminals.

"It is really frightening, especially when you don't know that they have wandered off," says Janice Billingslea, of Fayetteville, Ga. Her 81-year-old mother-in-law has wandered "over a dozen times" in the past six years.

"I didn't think it was going to be this hard," Billingslea says. "She disappears so quickly."

"The first time it happened we were living in the city and early one morning she had gotten up and dressed herself and wandered off. We thought that she was in her room asleep." She had walked to the next county by the time she was located four hours later.