Is losing the ability to walk part of the Alzheimer's progression?

9 answers | Last updated: Mar 02, 2011
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Q
An anonymous caregiver asked...
My 85 year old father has been diagnosed with moderate Alzheimers, probably stage 5. This week he started having difficulty walking. He will sway and stumble. I took him to the doctor and he did not have a stroke. Is losing the ability to walk associated with the Alzheimer's decline process? Is his brain just losing the knowledge to know how to walk? Can he regain the ablity to walk normal?
 

A
Ladislav Volicer, M.D., Ph.D., is recognized as an international expert on advanced dementia care. He is a courtesy full professor at the School of...
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Unfortunately, losing the ability to walk independently is a very common consequence of progression of Alzheimer's disease. You might want to try some assistive devices but many patients are unable to use them. One device that may extend his ability to walk is Merry Walker - a walker with built in seat and a strap between legs that prevents falling. It is available from Merry Walker company at http://www.merrywalker.com/

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wrs said...

It could also be the onset of an infection. My mother will have difficulty walking when she is dealing with an infection. It is one of the signs that help me determine if she has a infection. So far she always responds to antibiotics and regains her ability to walk. Although each time she becomes a little bit weaker.

WRS

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frena said...

i'm not a doctor (disclaimer here) but i have worked with a lot of people with dementia over 20 years. and actually, in my experience is NOT normal for people with alzheimer's to have walking issues. it is quite unusual. it is very likely to indicate that something else is going on and therefore you need to get your person to the doctor for a real investigation.

things i've seen that affect walking have been found to be:

  1. normal Pressure Hydrocephalus (NPH) which is increasingly found to be involved in sudden walking changes in an elder. it's the development of pressure of fluid build-up in the brain and can be checked and even fully corrected. i've personally known 3 people now (and i live in a tiny AZ town), so there's more of that about than you might think. sometimes doctors don't think to check on this (look up NPH on google);

  2. infection, such as bladder or UTI's, really affect an alzheimer person's overall functioning profoundly;

  3. the usual suspects -- like ministroke or heart spasms of some kind;

  4. sometimes an injury or muscle problem which the person can't identify for the caregiver. people with alzheimer's often can't identify their problem, such as headache or muscle sprain. but they can demonstrate it (walking funny, being agitated or upset).

any unusual changes in a person with dementia really means: get them to a doctor for check-up. and if you aren't satisfied (for example, if they say, oh it's due to his alzheimer's and don't seem inclined to investigate further) then get a second opinion elsewhere.

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Redbeard said...

Both of my parents had Alzheimers and both ended up in wheelchairs towards the end. My father fell and bruised his hip when using a walker and once in a wheelchair never really regained the ability to walk with a walker, although he tried sometimes.

I don't think the brain totally forgets how to walk, but they do become slower and weaker. There seems to be a downhill progression of abilities that may or may not include walking.

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frena said...

however, the issues of old age walking issues are pretty much universal possibilities across all health conditions. just because some health issue occurs in a person with dementia does NOT necessarily mean it should be attributed to the dementia.

it is often more accurately attributable to old age and generally lowered immune systems. dementia is bad enough for families to deal with, without piling so much extra on it.

unfortunately we live in a time when most people have little to do with elders other than those in their own family. so most people have no idea what "normal" old age looks like for the majority of people.

basically what caregivers need to look for is a sudden change in health status -- whether a walking issue, emotional issue or whatever. it's the change that signals an issue, as opposed to the usual way of going on.

in dementia, those sudden changes needing attention include suddenly much more confusion, suddenly much more agitation, suddenly afflicted with walking difficulties. dementia itself doesn't include sudden downturns as its norm. so suddenly much-worse dementia means, "i'm really ill here, get me to the doctor!"

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jainnagraj said...

Any how avoid injuries due to fall in case person suddenly falls due to whatever reason while trying to walk. Many times things are so complecated naming one disease may be aproblem. Many border line cases.

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ngay said...

Apart from the disorientation my husband's legs became very weak (no stroke in scan) in November last year. By December he was in a wheelchair. His hallucinations increased and so in those few months he has become doubly incontinent, has to be fed and sleeps a lot. I am told every case is different. Incidentally he was hospitalised and given endless tests to see if there were any underlying problems, which there weren't. except low sodium which is now corrected, and he has had no improvement. He is slowly declining. He is 77.

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frena said...

wow, that's very extreme, especially for a comparatively young older man. have you asked for the NPH brain pressure test to be done? if you look up NPH (Normal Pressure Hydrocephalus), you'll find it is becoming more and more of an identified issue, especially in people presenting severe balance and walkign disturbance, plus increased hallucination and incontinence. the thing is, it is easily tested. i have now know three people who developed these kind of issues, were found indeed to have NPH, were treated (a minor surgery to implant a shunt)and then experienced a complete reverals of all their issues. They were also in their seventies. just ask your doctor for a referral to an expert who can explore this.

There are several very good websites on NPH and it IS a much more common issue than people realised formerly, apparently. one expert estimates that up to 25 percent of all elders in care and nursing homes, said to have alzheimer's. actually have NPH but were never investigated for it.

a good clue that possibly NPH is an issues is whene walking and gait disturbances precede the development of dementia. good luck with this.

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ngay said...

Thanks so much for your quick response. My husband has been having problems with his memory since 2004 and had noticably become worse during the following years. Had the symptoms over dressing strangely and forgetting names. His driving over the last 2 years became scary - so much so that I refused to drive with him as I have a spinal condition and a bump from behind would put me in a wheelchair and I couldn't risk that. (I told the eye doctor but he wouldn't tell my husband not to drive) The Alzheimers test showed he had lost spacial awareness., and he stopped driving when the neurologist told him to. His MRI scan showed a considerable shrinkage in his brain. If he had the NPH test and it showed pressure, my question is, he is now beautifully cared for, is at peace and I wonder whether he should be brought back a bit only to go through it all again and could cause him unnecessary misery for his remaining years. I love him to pieces and could not bear to see him suffering any more. Am about to attack the NPH sights. Thanks so much for your reply and hope to hear from you again. Nicola

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