Wandering Behaviors and Activities of Daily Living Among Older Adults With Cognitive Impairment

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Abstract

Purpose

The aim of the study was to examine the characteristics of wandering associated with preserved versus worsened activities of daily living (ADL) function.

Design

Longitudinal prospective design. Twenty-two cognitively impaired residents of an assisted living facility with over 450 observations were followed up to 8 months.

Methods

Hierarchical linear modeling techniques examine how wandering activity (episodes, distance traveled, gait speed), measured by a real-time locating system, may affect ADL (the Barthel index, the Functional Independence Measure [FIM]).

Findings

Wandering episodes were associated with increased ADL (B = 0.11, p ≤ .05, FIM); wandering distance (B = −4.52, p ≤ .05, the Barthel index; B = −2.14, p ≤ .05, FIM) was associated with decreased ADL.

Conclusion

Walking an average of 0.81 miles per week with 18 or fewer wandering episodes is associated with decreased ability to perform ADL.

Clinical Relevance

Tailored protocols that allow productive wandering with ongoing assessment for fatigue/other physiological needs to appropriately limit distance walked within wandering episodes are needed for this population.

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