Does Alzheimer's Disease Affect Your Ability to Walk?

Alzheimer's disease does not just affect the brain—it has an effect on the body as well. Historically, the emphasis and study of the symptoms of Alzheimer's disease were focused almost solely on cognitive issues, looking at what type of impairments develop such as memory, language, and behavior and what interventions and treatments were most helpful.

Mature couple hiking in the wilderness together
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More recently, however, there is an increasing awareness of the physical effects of Alzheimer's disease, especially on one's gait in walking. Understanding the physical impact of the disease is important for knowing what treatments and care might be required as the disease progresses.

Gait Changes

Gait refers to the motion and stride of walking. For example, people who have Parkinson's disease may have a shuffling gait characterized by hesitant steps and dragging feet.

In the early stages of Alzheimer's, the ability to walk often appears to be fairly well-preserved. In fact, some people with early-stage dementia can walk for miles each day. However, research increasingly shows that others with early-stage dementia do have some changes in their gait.

One meta-analysis involving nearly 10,000 participants found that slow or decreased walking pace was significantly associated with an increased risk for dementia and cognitive decline in geriatric populations.

While research points to a connection between gait changes and Alzheimer's disease, further research is needed before such signs may be considered a definitive predictor or indication of cognitive decline.

Executive Functioning Changes

Executive functioning includes the ability to plan, prioritize, apply knowledge, and make decisions. A decline in executive functioning is one symptom of Alzheimer's disease.

Researchers have noticed that some people with early dementia show a decline in gait and/or speed of walking when asked to simultaneously perform a task such as tapping a finger and walking or counting backward and walking—abilities that require executive functioning.

A second study found that poorer performance on the Trail Making Tests A & B, a common test that measures cognitive ability and more specifically executive functioning, was shown to be predictive of a decline in walking and mobility.

Another study published in Physical Therapy noted that slower walking speed was associated with poorer performances on both the Trail Making Tests and the Stroop test, another cognitive tool that assesses executive function.

Next Steps

With multiple research studies documenting a change in the ability to walk correlating with a decline in cognition, how does this impact the way we approach Alzheimer's disease and other types of dementia?

Watch your loved one walk. If you notice a decline in the stride or speed in walking that's not connected to a clear cause (such as arthritis or a history of a stroke), observe if there are any cognitive changes present. Consider asking a physician or psychologist to evaluate his cognitive functioning so that early detection and treatment can be provided.

Additionally, if your family member's primary concern is her memory and she's being evaluated for a possible diagnosis of Alzheimer's disease, be sure to report to the physician any decline in stride or speed in walking so that this can be taken into account in the evaluation.

Remember that some medications or combinations of medications can affect both a person's gait and balance as well as their cognitive functioning, so don't hesitate to ask the doctor about the medicines your loved one receives and their side effects.

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