Dementia is a neurological condition characterised by a decline in cognitive abilities, memory, and thinking skills. While its impact on memory and cognition is widely recognised, the effect of dementia on mobility is often overlooked. This impact can widely vary from person to person. Still, in some cases, the progressive nature of dementia can significantly affect an individual's ability to walk, balance, and engage in physical activities.
This article aims to explore the various ways dementia influences mobility, how it evolves across different stages of the disease, and what approaches can be taken to provide support and help lessen the effects.
What kind of dementia affects movement?
Several types of dementia can affect movement, and each has specific characteristics. Some forms of dementia that commonly impact movement include:
Parkinson's Disease Dementia (PDD): PDD is characterised by both cognitive decline and movement-related symptoms, such as muscle stiffness, tremors, and slow movements. It is often associated with the presence of Lewy bodies in the brain, which are abnormal protein deposits.
Frontotemporal Dementia (FTD): FTD primarily affects the frontal and temporal lobes of the brain, leading to changes in behaviour, personality, and language. In some cases, FTD can also cause movement disorders, such as muscle weakness, stiffness, and difficulties with coordination.
Vascular Dementia: This type of dementia is caused by reduced blood flow to the brain, leading to cognitive and physical impairments. Depending on the affected areas of the brain, individuals with vascular dementia may experience movement difficulties similar to those seen in stroke patients.
How and why does dementia affect movement?
The exact mechanisms through which dementia affects movement can vary depending on the specific type of dementia. However, common underlying factors include:
Neurological changes: Dementia is characterised by the presence of abnormal proteins and other cellular changes in the brain. These alterations disrupt the normal functioning of brain cells and connections, leading to motor impairments.
Loss of brain volume: As dementia progresses, brain cells may degenerate and die, resulting in a reduction in brain volume. Areas responsible for motor control and coordination can be affected, leading to movement difficulties.
Neurotransmitter imbalances: In some forms of dementia, such as Parkinson's disease dementia, there is a depletion of dopamine-producing cells in the brain. Dopamine is a neurotransmitter that plays a crucial role in regulating movement. Its deficiency can lead to motor symptoms like rigidity and slow movements.
Treatments and solutions for movement-related issues in dementia:
Medications: In some cases, medications can be prescribed to help manage movement-related symptoms in specific types of dementia. For example, medications that increase dopamine levels may alleviate motor symptoms in Parkinson's disease dementia.
Physical therapy: Physical therapy can be beneficial in maintaining and improving mobility. Therapists can work with individuals with dementia to address gait and balance issues, strengthen muscles, and provide exercises that enhance overall physical function.
Assistive devices: Walking aids, such as canes or rollators, can support individuals with dementia in maintaining mobility and reducing the risk of falls. Occupational therapists can also recommend assistive devices to help with tasks that require arm and hand strength.
Environment modifications: Creating a safe and supportive environment is essential for individuals with dementia. Removing tripping hazards, installing handrails, and using contrasting colours to highlight steps or doorways can enhance safety and mobility.
Caregiver support:Caregivers play a crucial role in assisting individuals with dementia in their daily activities. Proper training and support for caregivers can contribute to better mobility management and overall well-being for those with dementia.
Impact of Mobility on Independent Living with Dementia
Maintaining independence is crucial for individuals with dementia. However, regular incidents of knocking things over, frequent falls, difficulties with self-feeding, or maintaining personal hygiene might indicate a need for additional support. In the early and mid-stages of dementia, making slight adjustments to the home environment can help prolong independence.
Adapting the Home Environment for Better Living with Dementia
Enhancing mobility confidence can be achieved through simple modifications to the home:
Install handrails and supports in the bathroom.
Place night lights between the bedroom and bathroom to prevent falls.
Use rug tape to secure rugs and reduce tripping hazards.
Opt for flat-bottomed mugs with wide handles or travel mugs with lids for better grip and spill prevention.
Choose lightweight, colourful plates with high sides to facilitate eating.
Adapt cutlery with plastic tubing or Sugru for comfortable grip handles.
Consider a larger or simpler TV remote to ease operation.
Protect tablets and smartphones with bumper cases to prevent damage from drops.
Keep the floor clutter-free to minimise trip hazards.
Play music on the radio to lift spirits and reduce anxiety.
Engage in gardening activities like tending to indoor plants, using garden kneelers, or elevated garden planters.
Encourage bird feeding, bird box maintenance, and bee hotel care for an active outdoor routine.
Provide slippers with rubber soles for easy movement both indoors and outdoors.
Support rebuilding confidence after setbacks by encouraging short strolls in familiar environments.
Introduce handheld vacuum cleaners or long-handled dustpans and brushes for easier cleaning.
Finding the Balance: When Is Mobility Too Mobile?
While encouraging independent outings for those with dementia is acceptable, safety must be prioritised. Regular confusion or getting lost during walks can be distressing for the individual and caregivers. Engaging the person with dementia in a discussion can help uncover the reason behind their desire to leave the house, which may be as simple as wanting to see friends or seeking stimulation.
Instead of locking someone with dementia inside their home, consider using a sign inside the door to remind them of their condition and when someone will be visiting. Installing a door sensor with a pre-recorded message can also help. Additionally, providing a name tag with a contact number can be beneficial if they become lost or confused.
Building a Supportive Network
Getting to know neighbours and local shopkeepers can be advantageous in providing assistance if needed. Exploring local groups that offer safe exercise and social stimulation environments can also benefit individuals with dementia and their caregivers. By implementing these measures, we can support individuals with dementia in maintaining mobility, independence, and an improved quality of life.
Here are some frequently asked questions concerning how dementia can affect mobility.
How does dementia affect the ability to walk?
As dementia advances, it can lead to changes in gait and walking patterns. Individuals with dementia may experience difficulties in initiating walking, maintaining a steady pace, and navigating obstacles. They may also exhibit shuffling or hesitant steps and an increased risk of falling. This is mainly due to the cognitive impairments affecting motor planning and coordination, making it challenging to execute complex movements like walking.
Does dementia affect balance and mobility?
Yes, dementia can significantly impact balance and mobility. As the condition progresses, individuals may have trouble maintaining their balance while standing, leading to an increased risk of falls. Additionally, spatial perception difficulties and reduced awareness of the environment can further compromise mobility. Such changes can result in a cycle of fear and reduced physical activity, contributing to a decline in overall mobility.
At what stage does dementia affect mobility?
The impact of dementia on mobility can vary depending on the type of dementia and the individual's overall health. Generally, mobility issues begin to emerge in the moderate stages of dementia when cognitive impairments are more pronounced. At this point, individuals may start experiencing difficulties with coordination, gait, and balance. As dementia progresses to the severe stage, mobility tends to deteriorate further, and individuals may become wheelchair-bound or bedridden.
How does dementia affect physical activity?
Dementia can lead to a reduction in physical activity for several reasons. The cognitive decline impairs the individual's ability to plan and initiate activities, reducing their motivation to engage in physical exercise. Additionally, as mobility declines and the risk of falls increases, individuals may become hesitant to participate in physical activities for fear of injury. This lack of physical activity can exacerbate mobility issues, muscle weakness, and overall physical health, creating a detrimental cycle.
Does dementia affect body movement?
Yes, dementia can affect body movement in various ways. In addition to the changes in gait and balance mentioned earlier, individuals with dementia may experience a condition known as "apraxia." Apraxia refers to the difficulty in performing purposeful movements, even though there is no muscle weakness or paralysis. This can make simple tasks, such as using utensils or dressing, increasingly challenging.
Furthermore, the brain changes associated with dementia can also lead to muscle stiffness and rigidity, especially in some forms of the disease like Lewy body dementia and Parkinson's disease dementia. These motor symptoms further hinder mobility and overall movement.
Do people with dementia walk slower?
Yes, people with dementia often walk slower as the disease progresses. The cognitive decline and changes in brain function can lead to difficulties in coordinating movements and processing information from the environment. This results in a more cautious and hesitant gait, which slows down walking speed. The slower pace can also be influenced by reduced muscle strength and balance issues, both of which are common in individuals with dementia.
Does dementia cause weakness in arms and legs?
Yes, dementia can cause weakness in the arms and legs, especially in the later stages of the disease. The neurological changes associated with dementia can affect the nerve signals that control muscle movement, leading to muscle weakness and atrophy. As a result, individuals may find it increasingly challenging to perform tasks that require arm and leg strength, such as lifting objects, getting up from a seated position, or using stairs.
Dementia can have a significant impact on movement, leading to changes in gait, muscle weakness, and coordination difficulties. Different forms of dementia may affect movement in unique ways due to underlying brain changes and neurotransmitter imbalances. Understanding the specific movement challenges associated with dementia allows for targeted interventions, including medications, physical therapy, and assistive devices, to help maintain mobility and improve the quality of life for those living with the condition. Additionally, caregiver support and a safe living environment are crucial components in managing movement-related issues and promoting the well-being of individuals with dementia.