Can Dementia Cause Repetitive Movements Or Gestures
Dementia is a condition that affects millions of people worldwide, and it brings with it many changes that can be difficult for both the person experiencing it and their loved ones. One of the less commonly discussed but very real aspects of dementia is the development of repetitive movements and gestures. Understanding whether dementia can cause these behaviors is important for caregivers, family members, and healthcare professionals who work with people living with this condition.
What Happens to the Brain in Dementia
When dementia develops, it causes significant changes in brain function. The disease affects the parts of the brain that are responsible for memory, reasoning, behavior, and communication. As these areas of the brain become damaged, the person with dementia experiences not just memory loss, but also changes in how they move, speak, and interact with the world around them. These brain changes are not something the person can control or choose to stop, and they are not signs of intentional behavior or stubbornness.
The connection between brain damage and physical movements is direct and measurable. When the areas of the brain that control motor function and behavioral regulation are affected, people with dementia may begin to display movements that seem unusual or repetitive. These are not habits that developed over time or behaviors that the person chose to develop. Instead, they are direct results of the neurological changes happening in the brain.
How Dementia Affects Behavior and Movement
Behavioral and psychological symptoms of dementia, often called BPSD, include a wide range of symptoms that go far beyond just memory loss. These symptoms include agitation, aggression, wandering, refusal of care, and various other behavioral changes. Within these symptom profiles, certain behaviors like agitation and aggression are among the most frequent and consequential across different care settings, whether in hospitals or long-term care facilities. Additionally, psychotic symptoms affect a substantial number of people living with dementia, and these can also contribute to unusual movements or gestures.
The reasons behind these behavioral changes are often rooted in unmet needs and proximal stressors. For example, pain is associated with higher odds of care refusal, agitation, and depressed mood in people with dementia. When someone with dementia is experiencing pain or discomfort, they may not be able to communicate this clearly through words, so their body may express it through repetitive movements, restlessness, or other physical behaviors. This is why understanding the root cause of repetitive movements is so important for proper care.
Communication and Environmental Factors
One particularly important factor that influences behavior in dementia is communication style. Research has shown that the way caregivers and healthcare professionals speak to people with dementia can significantly impact their behavior. A communication style known as “elderspeak,” which involves infantilizing or overly simplified talk, has been documented to increase resistiveness to care during hands-on care activities in people living with dementia. This type of communication has been found in acute hospital settings, making it a priority target for reduction through health professional training.
When communication breaks down or becomes frustrating, people with dementia may respond with repetitive movements or gestures as a way of expressing themselves or coping with confusion and frustration. The inability to communicate effectively can lead to increased stress and anxiety, which may manifest as repetitive behaviors. Additionally, environmental triggers play a significant role in how people with dementia behave. Changes in routine, unfamiliar settings, or stressful situations can all contribute to the development or worsening of repetitive movements and gestures.
The Progression of Symptoms
Alzheimer’s disease, which is the most common form of dementia, affects memory, reasoning, and communication over time. It is a progressive condition, meaning that symptoms typically start mild and become more noticeable and severe as time goes on. Early signs may include forgetfulness, repeating questions, or losing track of time. These small changes grow more noticeable over time. As the condition progresses, daily tasks and communication can become increasingly challenging.
As dementia progresses, changes in brain function, communication barriers, and environmental triggers all contribute to behaviors that might seem intentional but are actually symptoms of the disease. The repetitive movements or gestures that may develop are part of this progression. They can include repetitive hand movements, pacing, rocking, or other physical behaviors that the person repeats over and over. These behaviors are not something the person is doing on purpose or something they can simply stop doing if asked.
Understanding Repetitive Movements in Context
It is important to recognize that repetitive movements and gestures in dementia are not random or meaningless. They often serve a purpose for the person experiencing them. Sometimes these movements are a way of self-soothing or managing anxiety. Other times they may be an attempt to communicate something that the person cannot express in words. In some cases, repetitive movements may be related to the person trying to perform a familiar task or activity from their past, even if they are no longer in a situation where that task is relevant.
For example, a person with dementia might make repetitive hand movements that resemble knitting or sewing if they spent much of their life doing these activities. Another person might pace back and forth repeatedly, which could be related to anxiety, restlessness, or an attempt to fulfill an unmet need. Understanding the context and potential meaning behind these movements can help caregivers respond more effectively and compassionately.
The Role of Unmet Needs
One of the most important concepts in understanding repetitive movements in dementia is the idea that these behaviors often reflect unmet needs. When a person with dementia cannot communicate their needs clearly, their body may express those needs through behavior. If someone is hungry, thirsty, in pain, too hot, too cold, or needs to use the bathroom, they may not be able to tell a caregiver directly. Instead, they might display agitation, restlessness, or repetitive movements.
This is why it is so important for caregivers to look beyond the behavior itself and try to understand what need might be driving it. Is the person uncomfortable? Are they bored? Do they need more social interaction? Are they confused about where they are or what is happening? By addressing the underlying need, caregivers can often reduce or eliminate the repetitive behavior.
Caring for Someone with Repetitive Movements
When caring for someone with dementia who displays repetitive movements or gestures, there are several approaches that can help. Creating a calming daily routine is one of the most effective strategies. Structure brings comfort and security, and predictable schedules give each day a sense of rhythm and reassurance. When a person with dementia knows what to expect, they often feel less anxious and may display fewer repetitive or agitated behaviors.
Engaging the senses can also be very helpful. Sensory experiences can unlock comfort and familiarity. The smell of baked cookies, the feel of a soft blanket, or the sound of birds outside
