Date Presented 04/04/19
This exploratory study examined the relationship between getting lost and demographic characteristics, such as age, gender, education, marital status, cognition, and diagnosis in older adults with memory loss due to neurocognitive disorders. No significant factors account for the variation between those reporting getting lost and those who do not among a sample of 160 patients, although the travel subtask of the Cognitive Performance Test was associated with increased odds of getting lost.
Primary Author and Speaker: Patricia Schaber
BACKGROUND: Getting lost can be a serious safety issue for older adults who are experiencing memory loss. For an individual with a neurocognitive disorder such as Alzheimer’s disease (AD), getting lost is the result of disorientation and an inability to recognize familiar environmental cues and increases the chance of residential change to a long-term care facility (White, Montgomery, & McShane, 2010; Serino, & Riva, 2013). By examining factors associated with an individual’s report of getting lost, health care practitioners can predict those most at risk and implement strategies to insure safety in community mobility. There are gaps in the literature examining the relationship between getting lost and demographic characteristics such as age, education, cognition, diagnosis, functional capacity, living situation, marital status, and gender.
PURPOSE: The aim of this exploratory study was to examine the factors related to an individual’s self-report of getting lost in older adults with neurocognitive disorders. The research question is, What factors, if any, are characteristic of older adults with neurocognitive disorders who report ‘getting lost’?
DESIGN: This study is a secondary data analysis of patients seen in a Memory Clinic in a Midwestern state. Data was obtained in a medical record review of the occupational therapy evaluation which was part of a comprehensive team evaluation for memory loss. Subjects were 160 patients evaluated by occupational therapy, 105 females and 55 males; mean age 74.6 years; 94.4% Euro-American with 15 years average of education.
METHODS: Mini Mental State Exam (MMSE) scores were obtained from a neurological exam and Cognitive Performance Test (CPT) scores were obtained by a licensed occupational therapist (Burns, 2016). Data was analyzed with SPSS software. A Spearman’s Rho correlation determined the strength of the association between variables. Using binary logistic regression, the dependent variable was a self/caregiver report of “getting lost” in familiar or unfamiliar locations or while driving.
RESULTS: In the regression analysis, no significant relationships were found between a report of getting lost and the demographic factors or cognition measures. When modeling the factors in a stepwise regression, travel subtask of the CPT was found to be significant. This indicates the travel is significant considering the effects of confounding factors. The odds of getting lost are over 62% greater for every decrease in scale value in the travel test.
CONCLUSION: Results of this exploratory study indicate no significant factors account for the variation between those reporting ‘getting lost’ and those who do not among a sample of older adults with diagnosed neurocognitive disorders.
IMPACT STATEMENT: Clinically, we cannot assume a person will have a higher risk of getting lost based on age, gender, marital status, or education. Even cognitive scores do not point to a higher incidence as a person ages. On further examination of the CPT subtasks, in a regression model, it appears that the Travel subtask was significant in accounting for the variation when considered with other confounding factors. This subtask could be further developed and studied to serve as a potential screening tool for older adults with cognitive loss.
RELATES TO RESEARCH PRIORITIES: Future research is needed to examine the experience of getting lost for older adults with neurocognitive disorders. A better understanding of the event can guide occupational therapy practitioners in strategies to insure safety in community mobility and daily activities.
References
White, E. B., Montgomery, P., & McShane, R. (2010). Electronic tracking for people with dementia who get lost outside the home: a study of the experience of family carers. British Journal of Occupational Therapy, 73(4), 152-159. doi:10.4276/030802210X12706313443901
Serino, S. & Riva, G. (2013). Getting lost in Alzheimer’s disease: A break in the mental frame syncing. Medical Hypotheses. 80(4), 416-421. doi:10.1016/j.mehy.2012.12.031
Burns, T. (2016). Cognitive Performance Test manual. Maddak, Inc.
