Dementia is a condition that affects the brain and changes the way a person thinks, remembers, and behaves. One of the less talked about but very important effects of dementia is how it can make walking more difficult, especially when it comes to keeping balance. Many people with dementia find that they start to feel unsteady on their feet, are more likely to stumble, or even fall. This is not just because of getting older or weaker muscles, but because dementia itself changes the brain in ways that directly affect balance and movement.
The brain is like a control center for the whole body. It sends signals to the muscles, tells the body how to move, and helps a person stay upright and steady while walking. When someone has dementia, especially Alzheimer’s disease, the brain starts to lose some of its ability to do these jobs well. The parts of the brain that are responsible for balance, coordination, and movement begin to work less efficiently. This means that the signals from the brain to the legs and feet may be slower or less accurate, making it harder to walk smoothly and safely [1].
One of the main reasons dementia affects balance is because it damages the areas of the brain that process sensory information. When a person walks, the brain uses information from the eyes, the inner ear, and the nerves in the feet to understand where the body is in space and how to adjust to changes in the ground or movement. Dementia can make it harder for the brain to use this information, so a person might not notice if the floor is uneven or if they are starting to lean too far to one side. This can lead to stumbling or falling, even on flat ground [2].
Another problem is that dementia can affect a person’s attention and focus. Walking is not just about moving the legs; it also requires paying attention to the surroundings, planning each step, and making quick adjustments if something unexpected happens. People with dementia often have trouble with these mental tasks, which means they might not react quickly enough to avoid tripping or losing their balance. For example, if they see a small obstacle on the floor, they might not be able to stop or step over it in time, increasing the risk of a fall [2].
Dementia can also lead to changes in muscle strength and coordination. As the disease progresses, people may become less active, which can make their muscles weaker. Weak muscles, especially in the legs, make it harder to support the body and maintain balance while walking. In addition, dementia can cause changes in the way a person moves, such as taking shorter steps, walking more slowly, or having a shuffling gait. These changes can make walking less stable and more likely to result in a fall [3].
Balance is also affected by problems with vision and depth perception, which are common in people with dementia. The brain may have trouble interpreting what the eyes see, making it hard to judge distances or see obstacles clearly. This can make walking, especially in unfamiliar places or in dim light, much more dangerous [2].
There is also evidence that dementia can affect the way the brain controls automatic movements, like the rhythm of walking. Normally, walking is a smooth, automatic process that does not require much conscious thought. But in dementia, this automatic control can break down, making walking more effortful and less steady. People may need to think more about each step, which can be tiring and increase the risk of mistakes [3].
It is important to note that not everyone with dementia will have the same problems with balance. The severity of balance issues can depend on the type of dementia, how far the disease has progressed, and the individual’s overall health. Some people may have mild balance problems, while others may become very unsteady and need help to walk safely [2].
Research has shown that physical activity, including walking, can help slow down some of the changes in the brain that lead to dementia and may also help with balance and movement. Studies have found that people who walk more each day, even if they already have signs of dementia in their brains, tend to have slower decline in both thinking skills and physical abilities, including balance [1]. Walking programs that are tailored to the individual’s abilities can improve not only balance but also overall quality of life for people with dementia [3].
In summary, dementia influences balance while walking by changing the way the brain processes sensory information, controls movement, and maintains attention. These changes make walking less stable and increase the risk of falls. However, staying active and doing regular walking exercises can help support balance and slow down some of the physical effects of dementia.
Sources
[1] Science Media Centre. Expert reaction to study on physical activity (number of steps) and Alzheimer’s disease-related decline. https://www.sciencemediacentre.org/expert-reaction-to-study-on-physical-activity-number-of-steps-and-alzheimers-disease-related-decline/
[2] PMC. The comprehensive impact of exercise interventions on cognitive function in Alzheimer’s disease. https://pmc.ncbi.nlm.nih.gov/articles/PMC12599043/
[3] Dr.Oracle. Walking Regimen for Alzheimer’s Disease. https://www.droracle.ai/articles/479591/what-is-the-recommended-walking-regimen-for-individuals-with
