Dementia and Falls

• Alzheimer's dementia patients in the medium to advanced stage commonly have walking and balance difficulties. 

• This can be due to other causes or due to the dementia itself.

• Dementia patients commonly slow up, develop a flexed, stooped posture, become unsteady, dizzy, have reduced co-ordination and increased falls risk.

• Progressive unsteadiness and asynchrony of balance with prominent rigidity of upper and lower limbs can be common.

• Dementia is commonly associated with a multi-system brain atrophy (shrinkage) which results in a neurodegenerative walking and balance disorder.

• Typical features of the walking and balance decline in dementia include difficulty getting out of a chair, difficulty planning how to get back into the chair, slowed up, flexed posture, wide base of stance, hanging onto furniture when walking in the house (furniture cruising), unsteady turning, forgetting to use their walking aid, taking multiple steps to turn, freezing when spoken to whilst walking, getting lost and having recurrent falls.

• Postural hypotension or low standing blood pressure is a common cause of falls in dementia.

• Adverse drug reactions are a very common cause of falls in dementia including blood pressure and heart pills, sedatives, sleeping pills and anti-psychotic medications.

• Malnutrition with muscle weakness is a common cause of falls in dementia.

• Falls can be reduced in dementia with holistic multidiscplinary general medical care.

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.