Dementia-related gait changes (DRGC) mainly include decrease in walking speed provoked by a decrease in stride length and an increase in support phase. More recently, dual-task related changes in gait were found in Alzheimer's disease (AD) and non-Alzheimer dementia, even at an early stage.
I found that people with both types of dementia could be distinguished from the normal ageing group based on their walking pattern. They walked slower with shorter steps, were more variable and asymmetric, and spent longer with both feet on the ground compared to control subjects.
Some patients with Alzheimer's disease have walking difficulties. When these difficulties occur, patients walk with slow and irregular steps and find it hard to negotiate turns, climb onto a stepping stool, avoid obstacles in their path, or lie down and rise from the doctor's couch.
Mobility. Dementia is likely to have a big physical impact on the person in the later stages of the condition. They may gradually lose their ability to walk, stand or get themselves up from the chair or bed. They may also be more likely to fall.
In the late stage of Alzheimer's, the person typically becomes unable to walk.
There are different personal risk factors that cause people to fall, however, people with dementia are at greater risk because they: are more likely to experience problems with mobility, balance and muscle weakness. can have difficulties with their memory and finding their way around.
Previous research demonstrated that declining gait speed is associated with dementia. Further, several earlier studies showed that a dual decline in both gait speed and cognitive function is a better predictor of dementia risk than either measure alone.
Vascular dementia and mobility difficulties often go hand in hand. Vascular dementia is degenerative meaning it gets worse over time although it may be possible to slow progression and to better manage symptoms.
Is this common? Shuffling of the feet in a person with Alzheimer's or dementia typically occurs in the moderate to severe to later stages of the disease. Shuffling is a common cause of falls in affected people because sliding feet can more easily trip on rugs, door thresholds or even slightly uneven surfaces.
For people living with vascular and frontotemporal dementia, experts agree that muscle weakness and limb paralysis is often due to a series of mini, or large strokes in the brain. Both of these can massively impair someone with a range of physical as well as cognitive damage.
An unsteady, staggering gait is described as an ataxic gait because walking is uncoordinated and appears to be 'not ordered'. Many motor activities may be described as ataxic if they appear to others, or are perceived by patients, as uncoordinated.
Parkinson's disease dementia starts as a movement disorder, with symptoms such as slowed movement, muscle stiffness, tremor, and a shuffling walk.
Scientists at the University of Pittsburgh Graduate School of Public health discovered that a slow walking pace can be related to shrinking of the right hippocampus. This part of the brain is not just associated with the ability to keep good posture, but also memory, and thus provides the link to dementia.
In vascular dementia, problems walking or balancing can happen early. With Alzheimer's, these symptoms usually occur late in the disease.
During the middle stages, people may experience depression, anxiety, irritability and repetitive behaviors. As the disease progresses, other changes may occur, including sleep changes, physical and verbal outbursts, and wandering.
Administration: The examiner reads a list of 5 words at a rate of one per second, giving the following instructions: “This is a memory test. I am going to read a list of words that you will have to remember now and later on. Listen carefully. When I am through, tell me as many words as you can remember.
People with dementia often experience memory loss. This is because dementia is caused by damage to the brain, and this damage can affect areas of the brain involved in creating and retrieving memories. For a person with dementia, memory problems will become more persistent and will begin to affect everyday life.
The average life expectancy figures for the most common types of dementia are as follows: Alzheimer's disease – around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimer's live for longer, sometimes for 15 or even 20 years.
Those who walk more slowly and show declining cognitive function like memory loss are at a higher risk of developing dementia.
Additionally, older individuals often adopt a “cautious” gait pattern characterized by slower walking speed, reduced step length and increased variability in step timing. This gait adaptation is more apparent on irregular than level surfaces and may be a mechanism to increase head and pelvis stability in older adults.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
other long-term health problems – dementia tends to progress more quickly if the person is living with other conditions, such as heart disease, diabetes or high blood pressure, particularly if these are not well-managed.
I'm going to discuss five of the most basic ones here: 1) Don't tell them they are wrong about something, 2) Don't argue with them, 3) Don't ask if they remember something, 4) Don't remind them that their spouse, parent or other loved one is dead, and 5) Don't bring up topics that may upset them.