Alzheimer’s and the Ability to Walk

Dementia can affect areas of the brain that are responsible for movement and balance. Because of this, many individuals affected by Alzheimer’s and other types of dementia can 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

A crucial and sometimes neglected part of dementia care is the observation of gait. Gait refers to the motion and stride of walking. 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. When a person with Parkinsonism turns, they no longer pivot on their heels, but instead turn in a series of short steps. During the turns, their balance can become unstable; and are likely to fall backwards.

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.

Care for a person with dementia who is immobile enough can become difficult. Many other problems can develop, such as constipation, blood clots and pressure sores. If you or a loved one needs home care assistance or relief, our team can help: Contact us today.

Sources:

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

20 thoughts on “Alzheimer’s 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.

  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.

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