Abstract
BackgroundDementia-related missing and subsequent deaths are becoming serious problems with increases in people with dementia. However, there are no sufficient studies investigating the incidence rate, the mortality rate, and their risk factors.MethodsAn ecological study aggregated at the Japanese prefectural level was conducted. Dementia-related missing persons cases and deaths in 2018 were extracted from the statistics of the National Police Agency in Japan. We extracted variables about older adults’ characteristics, care, and safety as candidate variables considered to be relevant to dementia-related missing persons cases and deaths. Associations of the candidate variables with the incidence and mortality rates were analyzed using the generalized linear model (family: quasi-poisson, link: log) adjusted for confounding factors (proportion of older adults and gross prefectural product).ResultsThe incidence rate and mortality rate per 100,000 person-year was 21.72 and 0.652 in Japan, respectively. One facility increase in the number of nursing care facilities for older adults per 100,000 persons aged 65-years-old or more was associated with a 7.9% (95% confidence interval [CI], 3.3–12.4%) decrease in the incidence rate. One increase in the number of public health nurses per 100,000 persons was associated with a 3.2% (95% CI, 1.6–4.9%) decrease in the incidence rate. A ten percent increase in the proportion of people who live in an urban area was associated with a 20.3% (95% CI, 8.7–33.2%) increase in the incidence rate and a 12.9% (95% CI, 5.6–19.8%) decrease in the mortality rate.ConclusionsIdentified associated factors may be useful for managing or predicting dementia-related missing persons cases and associated deaths.
Highlights
The prevalence of Alzheimer’s disease has increased rapidly with the growth of the older adult population, and it is expected that the 33.9 million cases currently estimated worldwide will triple by 2050.1,2 Wandering behavior is one of the most troublesome dementia behavior disturbances and leads to several adverse outcomes such as fractures, getting lost, and untimely death.[3,4,5] The number of dementia-related missing persons cases is increasing, with 16,927 cases per year being reported in Japan.[6]
If the family or other related persons report that a missing person has dementia, this case is treated as dementia-related missing incident
We found that the number of nursing care facilities for older adults, number of public health nurses, and proportion of people who live in the urban area were associated with dementia-related missing incidents
Summary
The prevalence of Alzheimer’s disease has increased rapidly with the growth of the older adult population, and it is expected that the 33.9 million cases currently estimated worldwide will triple by 2050.1,2 Wandering behavior is one of the most troublesome dementia behavior disturbances and leads to several adverse outcomes such as fractures, getting lost, and untimely death.[3,4,5] The number of dementia-related missing persons cases is increasing, with 16,927 cases per year being reported in Japan.[6]. Some studies investigated the characteristics of missing persons cases and their risk factors. One study found that 75% of older adults with dementia died after going missing due to hypothermia or drowning and that the proportion of older adults living alone who died after a missing event was higher than those found alive.[10] Another study reported that persons who died after going missing were more likely to get lost at night (from 18:00 to 5:59) and that it took a longer time to submit a missing person’s report for persons who died than for persons who were found alive.[11] Another retrospective observational study found that a higher outdoor landmark density was a significant geospatial factor for missing incidents related to dementia.[12]. There are no sufficient studies investigating the incidence rate, the mortality rate, and their risk factors
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