Objective: Wandering is one of the major behavioral problems of cognitively impaired individuals. This study describes wandering behavior of patients with Alzheimer's disease in their institutionalized environment. Such descriptive information is essential for the development of successful intervention strategies.
Design: Wandering was defined as locomotion without specific purpose. Daily activities of wandering by demented patients were videotaped for further analysis and description.
Materials and Methods: The subjects were three institutionalized patients with Alzheimer's disease whose clinical presentation included prominent wandering. The demographic and cognitive profiles of the patients are shown in Table 1. Informed consent was obtained from the patients and/or family caregivers. Videotaped behavioral observations for 24 consecutive hours yielded detailed descriptive data for the patients. The patients' 24-hour activities were divided into four categories, activities under physical care (including hygiene, nutrition, urination and defecation), recreation, free time and sleep. Locomotion of the patients was classified as purposeful, wandering (nonpurposeful) or unclassified.
Results: As shown in Table 2, wandering behavior mostly occurred during physical care or free time. In contrast, wandering was not observed during recreation or sleep. The patients started wandering most frequently while care for urination was provided. Time of wandering showed substantial variation: the total time for A was 2 hr, 43 min, 8 sec, for B 1 hr, 59 min, 52 sec and for C 41 min, 53 sec and the mean duration of one wandering episode for A was 2 min 16 sec, for B 9 min 39 sec, and for C 8 min 23 sec.
Conclusion: The study highlighted various wandering patterns. In general, wandering tended to be marked in specific daily life settings including urination and other physical care related situations. It was of special interest that wandering was markedly reduced during recreational activities. We conclude that therapeutic intervention, including recreation but not physical intervention, may improve wandering behavior.
Table 1. Patient profiles
| A | B | C |
| Age (years) | 79 | 76 | 69 |
| Sex | Female | Male | Male |
| Duration of illness (years) | 6 | 5 | 4 |
| CDR | 3 | 2 | 2 |
| MMSE | 2 | 12 | 12 |
Table 2. Particular situations in which each patient started wandering (%)
| A | B | C |
| Under physical care | 35 | 62 | 19 |
| During recreation | 0 | 0 | 0 |
| In free time | 65 | 38 | 81 |
| During sleep | 0 | 0 | 0 |
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