Lawrence Fong

Background: Despite people with dementia being at increased risk of going missing, we currently have limited knowledge about the factors that increase their exposure to harm during missing incidents. Objective: To compare characteristics of missing incidents and associated risk factors for harm in older people with and without dementia reported missing in the UK. Methods: Retrospective analysis of reported missing incident data from two police forces in England and Wales over an 84-month period (January 2015 to December 2021). Results: A total of 1540 missing incidents involving 1286 people ≥65 years were identified, of which 414 (27%) incidents were dementia-related. In most incidents, people with dementia were reported missing from their own home/neighbourhood, with approximately half being found by the police. Nine percent (n = 39) sustained significant harm, including one death. Older age, going missing at night and prolonged duration of going missing were associated with increased probability of harm. Approximately 14% of people with dementia and 11% of people without dementia experienced at least one repeat missing incident. Conclusions: Our study is the largest to date reporting on missing incidents among older people in the UK. Despite being a low frequency event, missing incidents are associated with significant risk of harm for older people with and without dementia. Preventative and timely interventions to prevent harm associated with missing incidents for those aged over 65 years with or without dementia are urgently needed.

Background: People with dementia are at increased risk of going missing, which can lead to severe harm and distress. Despite the need for a better understanding of how to support people with dementia and their families affected, research in this area remains limited. This qualitative study explored lived experiences of families affected by missing incidents, and carers’ and professionals’ perspectives of how to improve care. Methods: A multi-perspective, qualitative framework analysis approach was undertaken with purposive sampling. Topic guides were developed in consultation with carers and professionals. We conducted in-depth semi-structured interviews and a focus group with key stakeholders (n = 33), which included carers of people with dementia (n = 9), police officers (n = 6), healthcare professionals (n = 12) and researchers (n = 6). Data were interpreted using thematic analysis to identify key themes. Reflexivity was considered throughout the process. Results: Five key themes were identified: (i) risk and protective factors of missing incidents, (ii) gaps in reporting and response pathways, (iii) the use of technology for preventing and responding to missing incidents, (iv) the role of communities in prevention of harm, and (v) the need for integration of services through multi-agency collaboration. Conclusion: This study highlights key gaps on our national and global response to missing incidents in dementia. Understanding risk and protective factors and improving our public health response through multi-agency collaboration and clear care pathways, were considered key by stakeholders. Our findings offer actionable insights to inform future strategies and improve care for people with dementia who go missing.

Background: People with dementia are at risk of going missing while walking outdoors, which can significantly affect their safety and well-being. However, evidence on their lived experiences during such incidents, as well as on strategies that may improve care remain limited. Aim: To conduct a narrative synthesis of qualitative studies exploring the lived experiences and preferences of people with dementia, family carers and professionals in relation to strategies for supporting safe walking and preventing missing episodes in both community and residential care settings. Methods: Four electronic databases (Medline, Embase, PsycINFO and CINAHL) were systematically searched up to April 2025. Studies were appraised using the Critical Appraisal Skills Programme qualitative research checklist. A narrative synthesis framework was adapted to explore themes emerging within and among studies. Results: Of the 19 207 articles identified, 25 met the inclusion criteria. Four themes emerged: (a) emotional impact of missing episodes, (b) safe walking as a fundamental need for people with dementia, (c) existing strategies for safe walking and responding to missing episodes and (d) experiences of using technological solutions to prevent and manage missing incidents. Conclusions: Preventive and reactive strategies, including technological devices, can promote safe walking for people with dementia. There is an urgent need to embed safe walking plans within dementia care packages to mitigate harms associated with missing incidents. Initiatives that raise awareness of risk among people with dementia, carers and professionals should form a core component of clinical practice.