Mobility Decline In Older Adults With Dementia

Mobility Decline In Older Adults With Dementia -What You Must Know

For older adults, a decline in mobility, meaning a decrease in the ability to independently move about, such as no longer being able to climb stairs, get up from a chair unassisted or to easily walk without fear of falling, is one of the most important predictors of both a decrease in health status as well as the overall quality of life. Loss of mobility not only affects physical health but greatly impacts a person’s emotional and social well-being.

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Why Do Older Adults Lose Their Mobility?

There are various reasons why people lose mobility as they age, including a progressive loss of muscle mass and strength, poor balance, and changes in a person’s gait, meaning how they walk. Various medical conditions such as painful joints from arthritis, movement-related disorders such as Parkinson’s disease, medication side effects such as dizziness, or muscle weakness due to a recent hospitalization can also contribute to mobility loss. Many older people are sedentary, adding to their muscle weakness and lack of strength, leading to a downward spiral of decreasing mobility.

But perhaps the most serious consequence of the loss of mobility is the alarming increase in risks of falls as people age. According to the Centers for Disease Control and Prevention (CDC), 36 million older adults aged 65 or older fall each year, resulting in 32,000 deaths, making falls the leading cause of injury and injury deaths in this age group, not to mention the burdensome economic and emotional costs of these falls to both patients and their loved ones. Many of these falls result in hip fractures, which can not only result in loss of independence but can greatly increase the risk of dangerous complications such as a blood clot in the legs or lungs.

Dementia And The Loss Of Mobility

Patients with dementia and their families bear an even greater burden, as not only do these patients have to cope with mobility declines associated with ageing, but also the decline in mobility associated with dementia itself. As dementia progresses, the person will gradually have more and more difficulty with walking, standing or getting themselves up from a chair or the bed. Of course, this puts them at an even greater risk for dangerous falls and a possible hip fracture or head injury.
Every year, forty to sixty percent of individuals with dementia suffer falls, leading to injuries including fractures, deaths, increasing health care costs and family distress. In people with dementia, there may be times when they become agitated and act impulsively. This tendency to impulsive action has been shown to be a contributor to the risk of falls in patients with dementia living in long term care facilities.

What Can Be Done About Mobility Decline?

So what can be done to prevent this decline in mobility, particularly with those who have a diagnosis of dementia?
A primary cause of a decline in mobility in older adults, whether or not they have been diagnosed with dementia, is a lack of physical activity or exercise. Many older adults simply spend too much time sitting, as do older adults with dementia. Of course, any underlying medical conditions related to a mobility decline, such as pain from arthritis, should be treated by a physician. Assistive devices such as a walker, cane, scooter or even a wheelchair when necessary can help to restore mobility to some extent. 

One of the most important, yet often overlooked interventions in helping to prevent mobility decline in older adults, particularly those with dementia, is companionship. Not only does interaction with a caring, professional individual help to stave off feelings of loneliness and isolation, but the person will also benefit from gentle encouragement to actively move about, go for walks, and engage in those activities of daily living in which they are still able to participate. The presence of a trained companion also provides a safety factor, particularly if the person becomes agitated.

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