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Medical Forum / Diseases and Disorders / Alzheimer's / November 200690 y/o compulsive walking
My great aunt is 92, physically fit, alert and observant, and can hold a conversation and has no medical problems apart from a very poor short term memory (of recent hours, days, & years) and is considered a dementure sufferer. In the last few months she has become a compulsive walker, she can't stop walking. From the moment she wakes in the morning until she falls into bed totally exhausted around 10pm she must walk--around and around the corridors of the nursing home, stopping to talk to any visitors only for a moment and then she's off again. She knows she is doing it, but just has to keep on walking. The nurses have tried sleeping tablets and painkillers, but neither has brought about any change. She herself doesn't have an explanation, sees the funny side of it and jokes with onlookers as she comes around on each pass, going at a quick pace. Is compulsive walking a recognised effect of some dementure sufferers? Is there any medication that might offer help in reducing this compulsion to walk? (N.B., she is not pacing the building desperately searching for an escape route like some confined patients do.) -- John Savage (my news address is not valid for email) > ... > Is compulsive walking a recognised effect of some dementure sufferers? > Is there any medication that might offer help in reducing this compulsion > to walk? (N.B., she is not pacing the building desperately searching for > an escape route like some confined patients do.) John, I have seen some other patients who do this, though I doubt that it's common and don't know if it's a symptom of dementia. Is it really a problem? It's probably good for cardiovascular and muscle health. It gives her a good night's sleep every night. It doesn't hurt anyone. I'd think there are worse ways that a person could spend the day in an Alzheimer's home. Following the adage of "If it ain't broke...", I'm not sure you really want to "fix" this one. Alan > My great aunt is 92, physically fit, alert and observant, and can hold a > conversation and has no medical problems apart from a very poor short term [quoted text clipped - 19 lines] > -- > John Savage (my news address is not valid for email) Hi John, I am not an expert and my comments are purely meant as an observation, but there were two people who were in the nursing home my mother in law was in, who had the same problem. They would pace and pace until they were exhausted and literally could walk no more. I may be wrong, but I think it is just how some peoples' brains are affected by the illness, or possibly which area of the brain deteriorates first. I have as I said, seen it in two people who were ill at the same time as Ida was. I can imagine it is very frustrating to deal with. The nursing home just let them pace around from what I could see, but then it was daylight and time for people to be up and about. I imagine it is only a tiny bit better than having someone who is not able to walk and to keep falling down. Not that either way is good.  SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') Compulsive pacing tends to be associated with FTD - the frontotemporal lobe dementias. It can be a huge problem in that unless restrained, some will literally pace their feet off - ie. 20 hours a day on frail feet and legs that can't take that much wear and tear, plus using up more calories than the person can take in, leading to weight loss, and frailty that can result in falls. M > Compulsive pacing tends to be associated with FTD - the frontotemporal > lobe dementias. It can be a huge problem in that unless restrained, [quoted text clipped - 4 lines] > > M Mary your comment makes sense as my FIL (with vascular frontal lobe dementia) also did this as part of sundowning behavior. Once the light started to shift around 3 or so, he just did laps around the building until he was exhausted. During the lighter parts of the day, he would interrupt his walking to talk or to gaze at the cows in the meadow next to the facility. But once the light shifted, it was very hard to get him to stop. Compulsive behavior is common in most dementias, and is an initial symptom in those whose brain is deteriorating from the frontal lobes first (Alzheimer's begins in the rear more parts of the brain. Mary's point about the frailty was a factor for my FIL. His hip fractured while he was walking. We don't know if he fell from a fracture or fractured it from a fall. The surgery to repair the fracture created a cascade of health problems with proved to be fatal. Now, please bear in mind he also had a cardiac condition, so he wasn't as healthy as your Great Aunt. For now, there was really no way to stop the behavior aside from 24 hour sedation or physical restraints - highly undesirable recourses. Even anti-depressants which have shown efficacy with compulsive behaviors only lessen the compulsion. If she is not on an antidepressant, your family might consider it. One of the actions of this medication is to make the parts of the brain 'talk' to one another better, prolonging functionality. There are some other medications, like Aricept, are supposed to slow the decline of dementias. Our family was never given that option, but it might be worth exploring. Adelle Mary_Gor...@tvo.org writes: > Compulsive pacing tends to be associated with FTD - the frontotemporal > lobe dementias. It can be a huge problem in that unless restrained, > some will literally pace their feet off - ie. 20 hours a day on frail > feet and legs that can't take that much wear and tear, plus using up > more calories than the person can take in, leading to weight loss, and > frailty that can result in falls. Sorry for the ... in your address Mary, but I'm reading off google. Yes, the concern is not over a moderate amount of exercise, but the exhaustion from ceaseless walking. She won't stop to eat or drink enough in hot weather, nor to rest, and by evening her gait has turned into a stagger with such a listing to starboard that it's ineviable she will end up taking a tumble. Have you any experience in predicting the likely behaviour if a broken hip forces her to be bed-ridden while the dementia wants her to be up and endlessly pacing the floor? The nurses do force her to wear padding on her hips, though understandably she hates its discomfort. -- John Savage (my news address is not valid for email) It seems the inhibition center in the brain has been destroyed by a stroke . To restore the balance you will have to put an electrode in and fry the excitatory part related to walking > My great aunt is 92, physically fit, alert and observant, and can hold a > conversation and has no medical problems apart from a very poor short term [quoted text clipped - 19 lines] > -- > John Savage (my news address is not valid for email) There is one lady in my fathers home who is well known for continuous walking, though she doesnt seem bothered by it (I have talked with her a few times). She is over 90 IIRC. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com it could be restless legs....You can't stop walking with that.... > Is compulsive walking a recognised effect of some dementure sufferers? This is common with frontal lobe dementias. > Is there any medication that might offer help in reducing this compulsion > to walk? (N.B., she is not pacing the building desperately searching for > an escape route like some confined patients do.) You should talk to her doc or a geriatric psychiatrist. Some anti-psychotics that can control compulsions and delusions may not work with frontal lobe dementias. |
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