Balance and Memory Loss (part 1): Are Physical Symptoms Connected to Alzheimer's?

On the plane back from visiting my mom for Thanksgiving, I read Scott McCredie’s Balance: In Search of the Lost Sense.  An entire chapter in the book is devoted to improving cognitive function by improving balance.

The chapter in Balance is mostly about people with learning disabilities, and about the vestibular systems in the inner ears.  It is not about Alzheimer’s or other types of dementia.  But it got me to wondering about any connection between balance problems and memory loss.

There’s nothing in Alzheimer’s Association or other patient literature about balance, but when I talk with people with memory loss, some say this symptom was the first sign of their cognitive problems:

• “My balance is deteriorating…my pace is slower, my steps uneven, and I have fallen a few times.”

• “My change in gait was the thing that initially led my family to seek further diagnosis.”

• [I was] “bumping into partitions, losing balance getting up from a chair, tripping on stairs…falling down….”

• [I had] “a number of falling episodes.”

• “I’d get out of bed and I’d just fall.  I wasn’t dizzy.”

I asked Joseph Friedman, MD,  Director of the NeuroHealth Parkinson's Disease and Movement Disorders Center in Warwick, Rhode Island and Clinical Professor at Brown University Medical School, whether screening for balance and gait problems is a routine part of an evaluation of memory loss.

“The usual neurological exam at the first visit does include evaluation of gait and balance,” he says, noting that some types of dementia can cause gait and balance problems in early stages, although it can depend on which area of the brain is affected.  “Alzheimer’s disease usually presents with isolated memory and cognitive dysfunction.  Vascular dementia and dementia with Lewy bodies, the two other major dementing disorders, certainly affect gait and balance early.  Advanced Alzheimer’s often includes parkinsonism.” 

So, if you have memory loss and balance problems, could physical therapy or any exercise help?  I’ll talk about that in my next post.

Comments

[David Thomas]

Hi. I have Lewy Body Dementia. Balance and gait problems are definitely part of the process. I have to do some daily exercises everyday which basically has me standing on one leg at a time while being near a sturdy object in case I fall. It has definitely helped.

David Thomas MD
http://knittingdoc.wordpress.com

[Gail Rae Hudson]

Well, I'm looking forward to part 2 of this one. Looking back, I think my mother's first signs of her vascular dementia were balance related. I can remember that before she began evolving certain curious financial assumptions, like, for instance, that if she paid off her minimum balance she had paid off her credit cards (which was definitely NOT an understanding that was typical for her), she was showing signs of being less spry on her feet. It took some years, though, for her to become so foot-iffy that it impaired her desire to go places and do things. Initially, she just walked a bit more slowly and carefully and I began keeping a sharp eye on her.
I can't recall, in any of her appointments, that she was ever formally assessed for balance, but, knowing her Mesa PCP, he probably informally made and noted observations.