UF researcher: more intensive search patterns may prevent deaths of lost Alzheimer's patients

December 10, 2003

GAINESVILLE, Fla. — Most Alzheimer’s and dementia patients who are found dead after becoming lost in the community stray no farther than a mile from their home or living facility, yet it may take days or weeks to locate them, according to a new University of Florida study.

UF nursing researchers have identified distinct patterns in these cases, yielding new insights likely to provide more efficient strategies for rescuers searching for those who wander.

Findings from the UF study, reported in the current issue of the American Journal of Alzheimer’s Disease and Other Dementias, emphasize the need for community members and law enforcement officials to use search methods specific to dementia patients so they are more likely to be found alive. These methods are especially vital when extreme cold or hot weather limits survival times for people stranded outside, and as a result, deaths are most frequent, researchers said.

“These (dementia-related) searches can vary greatly from a search for a healthy missing adult or even a child because of the dementia patient’s tendency to stick close to home in an isolated spot,” said Meredeth Rowe, the study’s principal investigator and an associate professor at UF’s College of Nursing. “Thus, law enforcement officers must conduct repeated searches that comb nearby areas thoroughly.”

Those who roamed not only stuck surprisingly close to home but also secluded themselves, and unlike most missing adults or children, they weren’t likely to respond when searchers called for them, Rowe said.

“There were no reports of these individuals responding to calls of searchers looking for them, even though searchers often were very close to where the individual was eventually found,” Rowe said. “The problem-solving skills of these individuals are impaired, so when they become scared, they may try to find protection from the outside world instead of responding to aid.”

Scientists estimate that approximately 4.5 million people in the United States suffer from Alzheimer’s disease, and this number could grow to 16 million by the year 2050.

For the study, funded by the UF College of Nursing, Rowe studied U.S. newspaper reports from 1998 to 2002 that described 93 incidents in which people with dementia died as a result of becoming lost. The news accounts described whether the person had a dementing illness, had become lost alone and had subsequently been found dead. Reports also included at least half the variables assessed in the study, including age, gender and residence, and details of how and where the person disappeared and was found.

Rowe’s previous research focused on tracking the patterns of missing dementia patients who were found dead or alive. Although only a small percentage of those found were dead, the deceased patients shared similar characteristics, spurring Rowe to launch the current study to pinpoint patterns and identify ways to prevent a tragic outcome.

“In our previous study, it was interesting that the few individuals found dead all were found in natural unpopulated areas, where it would be difficult for law enforcement to rescue and assist them,” Rowe said. “We discovered that many of the rescue searches that occurred may have come extremely close to the body without knowing it. Clearly, law enforcement officials must be attuned to the specific needs of a search for someone with Alzheimer’s or dementia.”

Eighty-seven percent of the individuals in the current study were found in unpopulated natural areas around their homes, such as woods, bodies of water, fields, ditches, brush, wetlands, ravines or canals. Most left areas where they could be easily seen and secluded themselves in natural and abandoned areas, where they remained until they succumbed to the natural elements. In 68 percent of the cases, the cause of death was exposure to the outdoors, followed by drowning in 23 percent of the cases.

Sixty-five of the 93 deaths – about 70 percent – occurred in the warmest or coldest months of the year. It took more than a week to find the victims in a third of the cases.

“Since most patients are found alive, the first 12 hours of a search should focus on populated areas, such as residential yards, businesses, highways and sidewalks,” Rowe said. “However, after the first six to 12 hours, it is critical for law enforcement to intensively search natural and secluded areas in the one-mile radius of where the person disappeared.”

Caregivers should not try to logically deduce where dementia patients may have been wandering to when they became lost, such as a former home or business, Rowe said. A patient’s intended path is usually completely unpredictable, she said.

A recent search for a missing dementia patient in Jacksonville was aided by recommendations based on Rowe’s research, said Sgt. Michael Eason, supervisor of the Jacksonville Sheriff’s Office Missing Persons Unit.

“We patterned our grid search based on Dr. Rowe’s advice,” Eason said. “What we have found in the past – which is supported by this research – is that these searches are like finding a needle in a haystack. At times, the most sophisticated searches using technology and dogs do not succeed. We are now working on a training segment for our officers using Dr. Rowe’s research and expertise. I would recommend that police departments around the country have a specific procedure in place for these types of missing persons.”

Both Eason and Rowe stress that all caregivers, including trained personnel in assisted living facilities, waste no time in calling the police when a dementia patient becomes lost in the community and a brief cursory search is not successful. Because a search is greatly limited by the amount of daylight, a delay of even a couple of hours can make the difference between life and death, Eason said.

“The most important thing for caregivers to realize is that dementia patients all have the capacity to become lost, even in the best type of caregiving situations,” Rowe said. “Registering your loved one with a national database, such as the Alzheimer’s Association’s Safe Return program, provides a means of possible identification and return in the case that someone does become lost.”