People with dementia often face challenges with walking and maintaining balance, which can be quite puzzling. To understand why this happens, let’s explore the underlying reasons.
Firstly, dementia affects not just the mind but also the body. It can cause physical symptoms like unsteady gait and stiffness, often referred to as “parkinsonisms.” These symptoms are similar to those seen in Parkinson’s disease but are not the same condition. They can appear early in the disease and are a sign of mobility impairment.
One of the main reasons for balance issues is the way dementia impacts the brain’s ability to coordinate movements. The brain’s motor control systems are disrupted, making it harder for people to walk smoothly or maintain their balance. This disruption can lead to a shuffling gait, where people drag their feet instead of lifting them properly. This type of walking increases the risk of falls because it makes it easier to trip on uneven surfaces or obstacles.
Another factor is the loss of muscle strength and flexibility, which is common as people age. Weaker muscles in the legs and hips make it harder to lift the feet while walking, contributing to a shuffling gait. Additionally, joint pain from conditions like arthritis can limit movement, further affecting gait.
Vision problems can also play a role. If someone has difficulty seeing their surroundings clearly, it can be harder to coordinate their movements and maintain balance. Fear of falling, especially after previous falls, can lead people to walk with shorter steps and a more cautious posture, which can actually increase their risk of falling.
Medications, both those for dementia and other conditions, can sometimes cause dizziness or stiffness, making balance even more challenging. For instance, memantine, a medication used to treat dementia symptoms, can cause dizziness as a side effect.
Lastly, environmental factors like slippery floors or poorly fitting shoes can exacerbate balance issues. Making the home safe by removing tripping hazards and using mobility aids like canes or walkers can help reduce the risk of falls.
Exercise and physiotherapy are crucial in managing these challenges. Activities like calf raises, straight leg raises, and single-leg stands can improve balance. Physiotherapists can provide personalized exercises and advice on using aids like walking sticks or frames to enhance mobility and reduce falls.
In summary, people with dementia face walking and balance difficulties due to a combination of physical changes, medication side effects, and environmental factors. Addressing these challenges through exercise, physiotherapy, and home safety measures can significantly improve their quality of life.
