What is shadowing?

Shadowing is when a person with dementia closely follows a caregiver or another person around. A 2023 case report in the Journal of Alzheimer's Disease says the behavior is routinely documented in dementia and is also called clinging, stalking or trailing. Researchers have sometimes grouped it with wandering and sometimes with anxiety-based behaviors, and its causes are still not well understood.

People with dementia often follow a caregiver because they feel anxious in a world that has become confusing. A 2023 case report in the Journal of Alzheimer's Disease describes trailing as an effort to avoid being alone, similar to separation anxiety, and links it to difficulty recognizing surroundings. The Alzheimer's Association names fear and fatigue from trying to make sense of a confusing world as causes of anxiety.

There is no defined stage for shadowing. A 2023 report in the Journal of Alzheimer's Disease cites one study in which 8.5% of people with dementia shadowed, based on caregiver questionnaires, and another that found trailing in as many as 32% of people with moderate to severe dementia. The report suggests it can occur in typical Alzheimer's disease as well as rarer forms.

Respond to the anxiety behind it with reassurance and something to do. The Alzheimer's Association's advice for anxiety in dementia includes calming phrases such as 'You're safe here' and 'I will stay until you feel better,' involving the person in activities like music or art, giving their energy an outlet such as a walk, and reducing noise and distraction. A doctor can rule out physical causes.

In Alzheimer's, shadowing means the person closely follows a caregiver or another person. A 2023 report in the Journal of Alzheimer's Disease suggests it may occur in typical Alzheimer's because the disease affects brain regions involved in recognizing the outside world, including visuospatial skills, visual perception and understanding speech. Staying close to a familiar person may help ease the fear that follows.