Relationship between familiar environment and wandering behaviour among Korean elders with dementia

Aim. To explore the relationship between wandering behaviour and familiar environment in community-residing persons with dementia in Korea. Background. Numerous non-pharmacological interventions have been developed to decrease behavioural symptoms and to increase the quality of life among persons with dementia. Although the concept of familiarity is very important and environmental interventions using the concept should have been developed for persons with dementia, no study examining even the direct relationship between familiar environment and wandering has yet been published. Design. A descriptive, cross-sectional survey design. Methods. A convenience sample was gathered of 77 non-institutionalised, community-dwelling persons with dementia and their family caregivers in Seoul and Wonju, South Korea. Descriptive statics, Pearson's correlations, t-tests, and multiple regressions were used in the data analysis. Results. The mean age of persons with dementia was 76·9 years (SD 8·0) and their mean cognitive level score using the Mini-Mental State Examination was 13·51 (SD 6·10). Most persons with dementia (71·4%) had been diagnosed with known types of dementia such as Alzheimer's disease, multiple infarct dementia, mixed type or Parkinson's disease with dementia. A familiar feeling with the environment was associated with cognitive impairment (r = 0·32, p < 0·01) and physical dependency in activities of daily living (r = -0·38, p <0·01). In addition, a familiar feeling with the environment (r = -0·56, p < 0·001) and physical dependency in activities of daily living (r = 0·56, p < 0·001) were strongly related to wandering behaviour. Familiarity and physical dependency in activities of daily living were the significant predictors for overall wandering and they explained 45% of the total variance. Cognitive impairment was the only significant predictor on the subscale of spatial disorientation. Conclusions. It was found that a familiar feeling with the environment was an important factor affecting persons with dementia's cognitive and functional abilities as well as specific features of wandering. However, future research using a more reliable method is necessary to confirm the findings obtained in this study. Relevance to clinical practice. This study suggested that providing persons with dementia with a familiar feeling in daily clinical practice through establishment of familiar physical as well as psychosocial environment may have benefit to decrease wandering behaviour.