Joseph E. Ibrahim

Objectives Older people are vulnerable to becoming lost from home, especially if alone and in unfamiliar environments. Incidents of older persons becoming lost are frequently reported and often requiring a search and rescue (SAR) response. Becoming lost is distressing to the person concerned, their carer, and family and may result in physical injury and/or death. This study examined what factors are associated with death among older persons reported lost from home. Methods/Design A retrospective cross‐sectional study. Data were obtained from the International Search and Rescue Incident Database from 1985 to 2013. Participants comprised persons aged 65 years and older living in the United States. Individual, SAR incident, and environmental factors were analysed. The primary outcome of this study was lost person found alive or found dead on arrival. Relationships between categorical variables and outcome were summarised with contingency tables, chi‐squared test p ‐values (or Fisher's‐exact‐test), and odds ratios (OR) with 95% confidence intervals (CI). Association between continuous variables and outcome were examined using multiple logistic regression. p ‐value of <0.05 was considered significant. Results Among the 5242 SAR incidents, 1703 met the inclusion criteria, of which 87.8% ( n = 1495) were found alive and 12.2% ( n = 208) were found dead. Factors associated with death included: male gender (OR 1.46; CI 1.01–2.13; p = 0.048), cognitively intact (OR 0.32; CI 0.22–0.47; p < 0.001), prolonged SAR duration (OR: 1.028; CI: 1.021–1.035; p < 0.001), found in water/wetlands (OR 7.40; CI 3.37–16.24; p < 0.001), and extreme weather (OR: 2.06; 95% CI: 1.10–3.86; p = 0.024). Conclusions Older people have a fundamental human right to protection from preventable deaths. Findings indicate these rights are not being protected with deaths occurring frequently among older people who have become lost from home. To minimise fatalities, knowledge of factors associated with death could inform the development suitable assessment and intervention strategies for SAR teams and caregivers.