When a person suffers from dementia there's always a possibility that she or he will wander away from home or a care facility, an event that can have grave consequences. In a recent study of Midwestern long-term care facilities (nursing homes and assisted living facilities), researchers sought to discover whether relationships exist between the personality and behavior of patients before they develop dementia and their risk of wandering.

A random cluster sample of 108 nursing home residents and family member dyads was selected from a larger study being conducted at 28 sites. The strongest predictors of wandering were a higher degree of dementia and older age, which both significantly predicted less wandering behavior. After controlling for both age and degree of dementia, however, two premorbid characteristics, lower extroversion scores on an assessment of "past personality traits" and "negative verbalization" in response to stress, significantly predicted greater wandering behavior.

Although many people deal with stress by talking to others or keeping busy, dementia patients who had less extroverted personalities before they developed dementia may not opt for either. Rather, they may look for a private, secure place where they can be alone and to relieve stress in other ways. Finding such a place, however, may be difficult for them, given their current cognitive state, which could lead to wandering.

These results lend support to the view that wandering in persons with dementia can be an adaptive behavior reflecting premorbid personality traits and lifelong patterns of coping with stress. The findings of this study may help caregivers to plan and provide more effective individualized care for each person.

Song J-A, Algase D. Arch Psychiatr Nurs 2008;22(6):318-27.