Dementia Wandering and Spatial Awareness

Dementia is a progressive condition that affects the cognitive abilities of an individual, such as memory, language, and spatial awareness. Among the most challenging symptoms of dementia is wandering, which can put the affected person’s safety and well-being at risk. In this blog post, we’ll delve deeper into dementia wandering and spatial awareness, what causes it, how to cope with it, and what caregivers can do to keep their loved ones safe.

What is dementia wandering?

Dementia wandering is when an individual with dementia walks aimlessly, often without a clear sense of direction or purpose. Wandering can occur at any stage of dementia, but it’s more common in the middle and later stages of the condition. It’s estimated that up to 60% of individuals with dementia wander at some point.

Wandering can be triggered by various factors, such as boredom, restlessness, confusion, fear, or trying to find a familiar place or person. It can happen indoors or outdoors, and it’s not uncommon for people with dementia to get lost or disoriented even in familiar environments.

Why is spatial awareness affected in dementia?

Spatial awareness refers to the ability to perceive and navigate through one’s environment. It involves various cognitive processes, such as depth perception, visual-spatial processing, and spatial memory. In dementia, these processes are gradually impaired, leading to difficulties in recognizing and navigating familiar spaces, such as rooms, hallways, or streets.

The decline in spatial awareness is due to the damage that dementia causes to the brain’s structures that are responsible for processing spatial information. The hippocampus, which plays a crucial role in spatial memory, is one of the areas that are most affected by Alzheimer’s disease, the most common type of dementia. As the hippocampus shrinks and deteriorates, people with dementia find it harder to remember and orient themselves in space and time.

What does the research say?

In this study, researchers were curious about why people with Alzheimer’s disease often seem to get lost or confused about where they are. They wanted to understand this problem better, so they did a study to look at the different kinds of skills related to knowing where you are in space.

They gave a bunch of tasks to two groups of people. One group had 15 people with early Alzheimer’s disease, and the other group had 15 people without the disease as a comparison. These tasks were divided into three types of skills: perceptual (how well you can see and understand your surroundings), cognitive (how well you can think and remember things related to space), and functional (how well you can do things like finding your way in a new place or a place you know well).

What they found was interesting. The folks with early Alzheimer’s disease struggled with half of the tasks that involved understanding what they saw around them (perceptual skills) and all of the tasks related to thinking and remembering things about space (cognitive skills). But when it came to doing things in a new place, they had trouble. However, they seemed to do just fine in places they were familiar with.

Now, why is this important? Well, imagine trying to go to the grocery store or even just taking a walk if you suddenly can’t figure out where you are or how to get back home. It’s not only confusing but also a bit scary. This problem limits a person’s ability to do things on their own, like running errands or visiting friends.

So, what can we do about it? The researchers suggest that occupational therapists (the folks who help people with daily activities) should check how well people can understand and navigate their surroundings, especially if they are in the early stages of dementia. This way, they can provide support and help these individuals stay as independent as possible for as long as they can.

What causes a person with dementia to lose spatial awareness?

Spatial awareness refers to our ability to perceive and navigate our physical environment. It involves understanding our position in space, the distance between objects, and the ability to navigate through space. For people with dementia, however, spatial awareness can be one of the first cognitive functions to decline.

Several factors can contribute to the loss of spatial awareness in people with dementia. One of the primary factors is the progressive deterioration of the brain caused by the disease itself. As dementia advances, brain cells die off, leading to changes in brain function, including those related to spatial awareness.

Another factor is the accumulation of abnormal proteins in the brain, which can disrupt communication between brain cells and lead to cognitive decline. These proteins, such as amyloid and tau, are characteristic of Alzheimer’s disease, the most common form of dementia.

The loss of spatial awareness can also be related to changes in sensory perception, such as vision and hearing. As people with dementia age, they may experience vision and hearing loss, which can make it more difficult to navigate their environment.

Furthermore, spatial awareness can be affected by changes in the brain’s white matter. White matter is responsible for transmitting signals between different areas of the brain. In people with dementia, the white matter can become damaged, leading to communication problems between brain regions and resulting in the loss of spatial awareness.

Finally, research suggests that changes in the hippocampus, a part of the brain responsible for memory and navigation, can contribute to the loss of spatial awareness in people with dementia. The hippocampus is particularly vulnerable to damage in Alzheimer’s disease, which can result in spatial disorientation and difficulty navigating familiar environments.

Is the loss of spatial awareness a common symptom of dementia?

Studies show that the loss of spatial awareness is a common symptom of dementia. In fact, up to 80% of people with dementia experience some form of spatial disorientation or navigational difficulties. This can be particularly challenging for individuals who live alone or have limited access to support and care.

The loss of spatial awareness can occur in different forms of dementia, including Alzheimer’s disease, vascular dementia, and Lewy body dementia. In Alzheimer’s disease, for example, the damage to the brain’s hippocampus, which is responsible for memory and navigation, can lead to disorientation and difficulty navigating familiar environments. 

In vascular dementia, changes in the brain’s white matter can result in impaired communication between brain regions, leading to spatial disorientation and difficulty with movement.

In addition to its impact on daily life, the loss of spatial awareness can also increase the risk of falls and accidents. This is because people with dementia may struggle to judge distances, trip over objects, or get lost in unfamiliar environments. 

It’s important for caregivers and loved ones to be aware of these risks and take steps to minimize them, such as removing obstacles from walkways, installing handrails, and ensuring that the environment is well-lit.

How can caregivers help a person with dementia who has lost spatial awareness?

The first step is to create a safe and supportive environment. This can be achieved by removing any obstacles or hazards from the person’s living space, such as loose rugs, clutter, or furniture that obstructs pathways. Installing handrails or grab bars in strategic locations, such as the bathroom or near stairs, can also help the person move around more safely.

Caregivers can also help the person with dementia by providing visual cues and landmarks. This can involve placing pictures, posters, or other familiar objects around the home to help the person orient themselves and navigate their surroundings more easily. Labeling drawers and cupboards can also help the person find what they need and reduce confusion and frustration.

Another important aspect of supporting a person with dementia who has lost their spatial awareness is to provide clear and simple instructions. This can involve breaking down tasks into smaller steps and using visual aids, such as pictures or diagrams, to help the person understand what they need to do. Caregivers can also use verbal cues, such as pointing to objects or giving directions clearly and concisely.

In addition to these strategies, caregivers can also provide emotional support and reassurance to the person with dementia. This can involve listening to their concerns and providing comfort and encouragement, as well as helping them maintain a sense of independence and dignity. Engaging the person in activities they enjoy, such as music or art, can also help improve their mood and overall well-being.

In some cases, it may be necessary to seek additional support from healthcare professionals or specialized services. This can include working with an occupational therapist to develop personalized strategies for improving spatial awareness or accessing respite care to give caregivers a break from their responsibilities.

Can spatial awareness be regained in a person with dementia?

Spatial awareness is the ability to perceive and understand one’s position in space and the relationships between objects in the environment. It is a complex cognitive function that can be affected by dementia, leading to difficulties with navigation, balance, and coordination. Many caregivers wonder if a person with dementia can regain their spatial awareness, and the answer is not straightforward.

In some cases, with the right interventions and support, a person with dementia may be able to regain some of their spatial awareness. Occupational therapy can be an effective way to help individuals with dementia improve their spatial awareness and develop strategies to compensate for any deficits. This can involve exercises to improve balance and coordination, as well as techniques to help the person better understand their environment, such as using visual cues and landmarks.

However, it is important to note that dementia is a progressive condition, and in many cases, spatial awareness deficits will continue to worsen over time. While interventions and support can help slow the progression of these symptoms, it is unlikely that a person with advanced dementia will be able to fully regain their spatial awareness.

It is also worth noting that every person with dementia is unique, and the severity and progression of their symptoms can vary widely. Some individuals may experience only mild spatial awareness deficits, while others may be severely affected. This means that the potential for regaining spatial awareness will also vary from person to person.

Regardless of the severity of a person’s spatial awareness deficits, there are still many things that caregivers can do to support their loved ones. This can involve creating a safe and supportive environment and removing any obstacles or hazards that could lead to falls or accidents. It can also involve providing visual cues and landmarks, breaking down tasks into smaller steps, and offering clear and simple instructions.

Are there any specific exercises or therapies that can improve spatial awareness in people with dementia?

Occupational therapy is one of the most common treatments for spatial awareness deficits in people with dementia. Occupational therapists can provide exercises and strategies to help individuals with dementia develop their spatial awareness skills. 

This can involve exercises to improve balance, coordination, and strength, as well as techniques to help individuals better understand their environment, such as using visual cues and landmarks.

Another therapy that can be beneficial for improving spatial awareness in people with dementia is cognitive stimulation therapy (CST). CST is a non-pharmacological intervention that involves group activities and exercises designed to stimulate cognitive function. In one study, researchers found that CST was effective in improving spatial awareness in people with dementia compared to a control group.

In addition to therapy, there are also specific exercises that can help improve spatial awareness in people with dementia. For example, visual scanning exercises involve scanning a room or environment for specific objects and can help individuals improve their visual attention and orientation. Balance exercises, such as standing on one leg or walking along a line, can also help improve balance and coordination.

Finally, several lifestyle changes can help improve spatial awareness in people with dementia. These can include getting regular exercise, maintaining a healthy diet, and engaging in social activities. These lifestyle changes can help promote overall brain health and improve cognitive function, which can lead to improvements in spatial awareness.


Dementia wandering and spatial awareness are complex and challenging aspects of dementia that require understanding, patience, and creativity from caregivers. By identifying triggers, securing the environment, establishing routines, and providing companionship and supervision, caregivers can reduce the risks and improve the quality of life of the person with dementia. 

However, caregivers may also face various challenges, such as stress, social isolation, safety concerns, and guilt. By seeking out resources and support, caregivers can find the help and encouragement they need to navigate the journey of caring for someone with dementia.

What are your experiences with dementia wandering and spatial awareness? Do you have any tips or insights to share with other caregivers? Please leave your comments and questions below.

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