Alzheimer’s disease and the Ability to Walk

Dementia inhibits the ability to walk

Dementia can affect areas of the brain that are responsible for movement and balance. Many individuals affected by Alzheimer’s and other types of dementia gradually lose the ability to walk and perform everyday tasks. Knowing what to expect can make an easier transition for you and your loved one in the late stages of dementia.

Understanding balance and gait

One of the first signs of loss of mobility, is walking unsteadily and shuffling. Your loved one may seem slow or clumsy, causing more accidents and bumping into things. This “slowing” is typically associated with a syndrome called “parkinsonism.” Other signs of Parkinsonism include the shortening of steps, “stooped” posture, and the narrowing of the space between feet. Turning can become more difficult, because the person no longer pivots on their heels, but instead turn in a series of short steps. During the turns, their balance can become unstable, increasing the changes that they fall backward.

Apraxia is another condition associated with dementia and the ability to walk. An ataxic gait is characterized by imbalance, and abnormal, uncoordinated movements. Typically the individual can stand, but is very unsteady, taking small irregular steps. Very early in the course of apraxic walking in dementia, a cane or a walker can help. It is not uncommon to see a person go from a slow, cautious gait, to a normal walking pattern simply by taking up a cane.

How you can help

  • It is important to note that people with dementia can have problems with walking that are not associated with dementia. Exhaustion and pain can limit how far a person can walk. Sometimes that pain can reflect an unattended problem in foot care or muscle fatigue.
  • The person you care for may also require a mobility aid, such as a walking cane or a wheelchair in order to feel secure. Sometimes just being physically present can provide your loved one with the confidence and security to walk.
  • Consider a physiotherapist: They can help with anything from exercises to strengthen muscles to walking aids.

It is not easy to care for someone with mobility constraints!  Unfortunately, this issue is usually compounded with others, including constipation, blood clots, and pressure sores.

It takes a team

We can be your team.  Falls can happen at any time, leading to permanent deteriorations in health, and it only takes a moment.  Let us be there when you cannot.  Call us today to learn how we help: 610-323-9800.

Sources:

Understanding Dementia: Balance and Gait Examination – DementiaGuide.com. DementiaGuide, 2001. Web. 23 June 2016.

47 thoughts on “Alzheimer’s disease and the Ability to Walk

    1. Hi Cassandra,

      Is your loved one using a roller walker, cane, or other device for mobility assistance? Sometimes there can be improvements through physical therapy. If changes are a result of a dementia, this is unfortunately part of the disease process.

  1. My father is 83 and one year ago was diagnosed with dementia. His gait is slowly becoming awkward and slightly unbalanced. He refuses to use a can. He feels that he will become too dependant on it. Will a cane help or hinder him? Can you explain why please.

    1. Hi Cynthia, unfortunately this is attributed to the progression of the disease. A good understanding of the disease progression is important for us to know. It allows us to change our approaches to connect before providing care. Would you like to learn more about our dementia care services? We are available at anytime to assist, 610-323-9800.

  2. My,mothwr has Vascular dementia ans unable to,walk..2 person assist and we use a hoyer and stand to sit lift for transfers….we are in,the proceas of purchasing a mobility van,to give her a bettwr quality of life. We gave Her primary care doctor a DMV form to sign so she would not be charged sales tax for disabled person….he refused to,sign it and says she doeant need a van? Is this even legal?

  3. I was wondering if walking become an issue with people with young onset Alzheimer’s or is this more due to age related issues!

    1. Hi Sharon, here is a great three-minute video that explains the typical stages of Alzheimer’s disease: https://www.youtube.com/watch?v=Eq_Er-tqPsA.

      Usually walking and gait issues increase with the progression of dementia. In summary, the brain is prioritizing the most important tasks (breathing, seeing, eating, digestion, walking, etc.). However, eventually the brain must also prioritize between these.

  4. My husband is 74 and diagnosed with dementia. 3 years ago he began to get tired, then he started using a cane, then went to Walker then wheelchair. Now he can barely get out of bed into chair. He was diagnosed until 2 years ago. We didn’t realize his inability to walk was connected to his dementia. We thought something was wrong with his back causing this. After going to 3 neurosurgeons, two neurologist and to Mayo Clinic we were told he had brain atrophy and there was nothing they could do. My heart is breaking. He is in his 3rd rehab. I don’t think I can care for him at home.

    1. Hi Norma. I am sorry to hear about your situation, but thank you for telling us about it. Unfortunately dementia eventually inhibits a person’s ability to walk. Have you found the support you needed? Would you like to talk more? I am sending you a private email now.

  5. My father is 79yo. There’s not a diagnosis on him yet. 4 months ago his wife of 55 years was diagnosed with liver cancer and she has 6 months to live. He took care of her 2 months and her sister took over. A 1 month later he fell over one day and has complete memory loss. Lost the ability to walk and barely can speak. Can this be Alzheimer’s disease or dementia when it happened so quickly he went from age 79 to 101 month span? Can the trauma due this him? Trigger dementia?

  6. Thank you for the article and comments. My mom has vascular dementia and is having trouble getting up out of chair. She uses a rollator. My dad is home with her. and I am feeling as if it is too much for him, Any ideas?

    1. Hi Joy, thanks for reaching out. Vascular dementia progresses differently than other types of dementia. Progression occurs in a “stepwise” way, versus a continuous decline. You should check out this article for more info: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314418/.

      It is really important to keep your mom active mentally and physically, without overexertion. You are trying to avoid strokes or any other disruption in blood flow.

      Your dad probably makes good company for your mom, but it could be dangerous to have him as the sole carepartner. Can a family member or a professional carepartner supplement your mom’s care needs to give your dad a break?

  7. My dad who has Alzheimer’s is having difficulty standing from his wheelchair. Once up he walks with assistance. Physical therapy says he is not making “adequate progress” so they say they cannot work with him. On some days he stands and walks well on others he cannot stand. Those days are usually when he hasn’t gotten up for a few days. He usually will get up if I am there. Should we pay out of pocket to keep him from being completely wheelchair bound. They now use a Hoyer lift to move him from chair to bed. Thanks for any info you can give.

    1. Hi Loretta,
      Thank you for telling us about your dad’s situation. As dementia progresses, mobility will decrease, and can stop completely. The brain is prioritizing which motions are most essential for survival, such as respiration, digestion, and sight. Mobility constraints are usually very hard for family members to accept. Today with the proper care, people can live a long time with Alzheimer’s disease, but this comes at the cost of seeing the disease progress completely.

      With this being said, there are still ways to engage your dad physically even if he does not get out of his wheelchair. He should be moving his legs and arms with a variety of exercises. If physical therapy no longer works with your dad, ask them for their latest physical therapy plan. A family member or professional carepartner can run through these exercises with him on a daily basis. If a family member is giving the physical therapy, it is important to look for signs of overexertion in order to allow your dad to rest.

      The finances for each family is different. If you think he may be eligible for Veteran Administration or privately held long-term care insurance funding, you may want to review his policies or consult an elder attorney or elder care coordinator. For any family, I would generally recommend at least three to five days of care per week, to address the activities of daily living, especially hygiene, nutrition, and physical mobility. Also, do not underestimate the importance of mental stimulation.

      1. My mom had her 2nd stroke 5mlmths ago and after being hospitalized for 2 weeks we sent her to aquarius ward for six weeks with her permission to become stronger and she did how beit a little. She had the first stroke 10uears ago and her left arm and leg were affected and w En ever knew the.n that mom had developed dementia becos of the clot on her brain.. This the doc inky said to us now with the 2nd stroke as the other side was affected and not the left side is more strongerhabing been weak for nearly 10lpmg years and she was disabled on that side. To date mom is being cared for by Catherine at night and during the day and dad also takes a turn and I having mommamdndad staying on our property.. We run in and out all the time and then my 3 siblings free up a roster and come in the evening each one each turn in the week mot works well right into weekends.. However our mommy is not moving much and mostly is on her hospital bed.. Everhothwr day we take her outside in the wheelchair in the yard and though week she loves it. Moms moods has so much changed her speech too and her inability to move herself and also being in a nappy.. It’s hard for her for us all.. And she needs 24/7 care
        What’s worrying is that mom is sometimes so very ugly with words to dad us and the care and cries of she doesn’t get her way. She still wants to be in command no matter how weak. She curses swears and threatens.. In essence mom rules us from her bed. Is this dementia.. Mom doesn’t recall well maybe the things prese tly bit longterm memory for sure to the detail of a color of a sweater.. She however also rbers dad’s unfaithfulness and doesn’t trust him even with the carer and therefore gives it to him and her verbally. As for us she acts very. Selfishly and also to her sister who recently visited her or anybody who we are socializing with other than mom. She verbalize the worst words ever. Please gkv ejs advice as mom is terrible and we love her and wish that she was kinder nicer to us all as we are seeing to her every need.

        1. Hi Virigina,

          This is a challenging situation. Ultimately your mom is trying to still exert control and is frustrated the limitations of her abilities. If you could channel this energy into other efforts, it might alleviate the negativity towards your family. Ultimately remember, this is not her, it is the disease. Try not to be hurt by her comments.

          Does your mom live within the Philadelphia metro area? We can complete an assessment if you want.

  8. My mom can no longer walk. She is in a memory unit and has full time care. They use a sit to stand lift to transfer her. My concern is weight gain. What can we do (other than lower carbs and portion control) to help her lose weight. It wasn’t an issue when she walked. Now she is putting on 4 lbs a month.

    1. Rebecca, it is hard to tell for sure without meeting your mom, but I can give some basic suggestions. Check the sugar and sodium content in foods, offering more nutrient rich items (as long as there are no known reasons not to). Increasing water consumption also helps with weight, but may make caregiving more challenging if being done by family. If sodium levels are high, it may also increase body water retention, and therefore weight.

      Try exercises that can be done in place, but moving the upper and lower limbs. A general physical therapy guide is a good place to start.

  9. My mother is 77 and has been suffering from the disease for over 10 years. She is wheelchair bound and stooped over, possibly due to scoliosis. Her progression has been slow but over the last 6+ months she has lost the ability to talk and, now, to walk. To the best of anyone’s guess, does this represent an acceleration in her decline toward death? Her overall physical health has been strong and our biggest fear is that she lives many more years this way. I can’t help but think these recent developments mean the end may actually be in sight…

    1. Hi John. I am sorry to hear about your mom. The disease takes its toll on all of us.

      The life expectancy really varies depending on the type of dementia and existence (or non-existence) of other health complications. However, ten years is a long time to live with the diagnosis. The disease does progress to take away one’s ability to talk and walk. Dementia is terminal on its own, but most people will pass away from other health complications such as pneumonia or another untreated illness.

      This is a good 3-minute video to watch: https://www.youtube.com/watch?v=Eq_Er-tqPsA.

      Remember there are still ways to connect with your mom and make life meaningful.

  10. Hello, my 84 y/o mother has alzheimer disease, it was diagnosed more than 12 years ago. She is not bedridden, she is very active, always moving around the house. She only sits down for a few minutes and gets back on her feet again. Recently she has been loosing her balance while walking (she’s kind of making sharp turns while walking). I’m worried she is going to fall and hurt herself. She is in a too advanced stage to understand what a roller is or to stay put in a chair. What choices do I have for avoiding falls, what can I do?

    1. Hi Dally, sorry I did not see this earlier. Feel free to call us at 610-323-9800.

      I would take steps to mitigate the fall risk. This means covering sharp corners, limiting your mom to one story of the home, and making sure she does not have to climb to reach items. We always recommend care in the home as an additional measure.

  11. My grandmother was diagnosed with Alzeihmers about 6 years ago. She’s been pretty much the same for the last few years, confused but pleasantly confused. She can hold conversations and walk and eat. Suddenly over the last two weeks she’s been falling a lot, refusing to eat, losing a lot of weight, and having difficulty swallowing. She is currently in the hospital and has almost no strength anymore and needs multiple people to assist her. She’s become i continent as well. Is this sudden decline normal with the disease or are we missing something? She’s gotten CT scans and most of her labs are normal, just needing some electrolyte repletion. We are now looking into long term care because this has all happened so fast and my family just isn’t capable or prepared for this. I’m very scared the end is very near due to all these gloomy signs.

    1. Kacie, sometimes there can be multiple conditions working against your grandmother simultaneously, such as a urinary tract infection or other unknown issue. It seems like you are doing the right thing by getting additional tests and having her see a physician.

      The symptoms you describe will be seen in those living with dementia. Everyone progresses at a different rate, dependent on their overall health and type of dementia. It is possible that she may be living with a vascular type of dementia, which progresses in a more step-like manner (less gradual), caused by temporary changes in the blood supply to the brain.

  12. My father is struggling to get out of his chair and now shuffling when walking ..it is getting worse by the day as he is sitting in a chair most of the day in a care home..if I do some leg excersises with him daily …will this help him walking ?.

    1. Hi David,

      I am sorry to hear about your dad. Has he seen a physical therapist? Usually they can put together a realistic exercise routine that you can continue on your own or with third party providers.

      Peter

  13. My 85 year old great grandma has been using a walker for years. She was diagnosed with dementia a couple years ago and has started falling a lot more recently. She can’t remember to use her walker when she needs to go somewhere. Is there anyway I can help her remember to use her walker? I just hate seeing her decline and I’m trying to do the best I can while I’m in college. I’ve thought about putting college on hold but I know my great grandma wouldn’t want that. She recently moved in with my grandma a couple of months ago and at first things started to get better, but now she’s getting worse again. Any recommendations will help!

    1. Hi Keely,
      I sure can empathize! I would suggest painting or decorating the walker with things she enjoys so that she wants to go to the walker. I had a patient who was a veteran refusing to use his walker, but after painting it red, white and blue, he now loves his walker. I’ve also seen some paint their walkers John Deer green for farmers, and/or gardeners and decorate with flower stickers. Hope this helps!
      Angie

  14. My husband has dementia and has been in dementia care for seven months now. It is progressing fast, but he still recognises me and we.share love. He is only 70yrs old, I am 68.He can no longer walk and it breaks my heart. All I can do is work with the staff and check on his treatment. All I can do is share my love with him and give him myself. I always let him know I love him and he says he knows. We have been married 47 years and we’re mid teens when we met. I miss him so much, I am still in love with him. Inside, I feel I am bleeding for him. I go to see him most days. I feel the hurt after being with him, but, I will Not abandon him. He is stuck with me. I hope he does not feel the pain I feel. I have good supportive friends abs a dementia support group I go to. I want my man back. Heather

  15. My mom has dementia and all of the sudden is walking with her back arched back. Like she is leaning backwards I’m afraid she might fall I don’t know if this is the disease progressing or something else

    1. Hi Luis. I am sorry to hear about your mom. These changes may be related to the disease. Mobility and vision are eventually affected by the progression of dementia. This may be your mom’s way of looking where she walks.

  16. Hello- my mother seemed to begin losing her ability to control her gait and her legs before we noticed signs of dementia. She is slowly becoming more confused thou she is lucid and has some intact memories (including new learning) on most days. This past year she is having difficulty standing and transferring. The admins at her assisted living have threatened to move her to a nursing home if this persists or worsens. (She has been in the attached nursing home and it is not a preferred option- we do not wish to move her so she can stay near her husband). Other than physical therapy, can you recommend ways to assist her? We have thought about lift chair, grab bars etc. there doesn’t seem to be guidance for anything at the facility. Thanks.

    1. Gina, it sounds like you are implementing good techniques. Unfortunately, the admin will eventually insist on moving to a higher level care unit, if your mom does not have additional assistance in the assisted living community. You may want to reach out to a provider to see if they can supplement care to keep your mom in her current place. If you want, give us a call to talk more: 610-323-9800.

  17. Please advice on Food, and supplement that would help my mother. I understand that Alzheimer can’t be cured but I usually talk her as nothing is wrong with her and she responds, sometimes she replies. Most of the times she wants to say but is unable to say the words. Evolving her in daily routine work. I always see her being more responsive. She is having trouble walking. However I still feel nutrition that would strength her muscles would help.. Please guide

    1. Winfred, nutrient dense shakes such as Ensure are a good place to start. Many people living with dementia begin to eat less. Gradually replace low nutrient foods with high nutrient foods (white bread with wheat bread) and always encourage water. One way to encourage drinking water is by pouring glasses and leaving them within sight. This serves as a remember and are convenient.

      Lastly, remember eating and drinking should be social activities. The more you do this together, the more likely she will eat and drink the needed amount.

  18. My husband diagnosed with MCI in 2014, had an MRI in 2018 showing significant shrinkage in his brain. He’s starting to experience his legs shaking. Goes away, but is bothersome. Having trouble with stairs, visual – spatial issues – very confused. Cannot see where the bath is; where the toilet is, where his foot lands when walking, so he’s very careful when walking. Little communication; very little understanding. Stage 5 early onset Alzheimers. Should I be worried about the tremors?

    1. Hi Maria. Sorry to hear about your husband, this is a very difficult disease and we hate what is does to those we love. All of these issues are in line with the progression of the disease. Tremors can be as a result of Parkinson’s or general anxiety. Please make sure you are changing the environment to make it more accessible to him. Try soothing background music and familiar smells and tastes. If you would like more ideas, give us a call 610-323-9800.

  19. Thank you for this wonderful blog. My mother has had Alzheimer’s for going on 12 years now, she’s 78 years old. Just this past week her caregivers began reporting that she’s having trouble swallowing, and is “pocketing” food. She has not been able to walk or talk for many months, and I believe this is the beginning of the end for her, which after so much time would be a merciful thing. Does anyone know about how long a final-stage patient typically lasts when the swallowing problems begin?

  20. How can my dad go one day with being able to walk on his own, though he was weak, and the next day he can’t walk or talk? The hospital says he didn’t have a stroke but I really don’t believe that.

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