My wife, who used to walk every where, now walks almost with a shuffle - very small steps - and slightly bent over. She also walks slower than usual. I think this is part of the process - the brain is not giving the correct information to the muscles.

I know my Hubby's walking is interferred with, partly from a TIA and partly from lingering med side effects. It's finally gotten to the point that occasionally I'm the one who is told/asked to slow down. Some years ago, he had separate knee injurieis, which required arthroscopic surgery to repair. Recently, he told his new Dr. his knee isn't like everybody elses. His knee cap is 1/2 way down hisa shin, and nobody can help him. He is already on prescription meds for pain. I bought him a knee support, the OTC kind. He's happy. Thn Sunday we went to thew store and he forgot to wear it. He confided to the greeter, not to tell on him, because I'd be PO'd. Go figure.

His waklking deteriorates when he's been more active or is generally tired. Weather fronts alsao affect him. Getting him to willingly use his 4 footed cane is spooradic and using his walker---forgetaboutit.

DH also walks hunched over and shuffles mostly too. i agree with Marsh, signals are misfiring/depleted again as will all body parts eventually-uh-oh? having something in the hand at all times?? yep, we have been in this one for some time now. the remote, play cellphone/candlestix/anything he can carry he will while walking. maybe its a feeling of balancing of sorts. everyhand is full as well as all pockets:) divvi

Interesting ... each year during the longitudinal study, they ask me whether my husband has started shuffling yet. I had vaguely thought I'd heard that its onset might be associated with eventually developing other symptoms, or something like that.

But when I google for AD and shuffling, I keep finding the shuffling gait is associated with Lewy body dementia. For example:

Lewy body dementia is a neurodegenerative disorder in which abnormal structures called “Lewy bodies” are found in the brain. People with Lewy body dementia frequently have symptoms of both Alzheimer’s disease and Parkinson’s disease. These symptoms can include traditional parkinsonian symptoms, such as loss of spontaneous movement (bradykinesia), rigidity (muscles feel stiff and resist movement), tremor, and shuffling gait. Symptoms of Alzheimer's disease include confusion, loss of memory, and fluctuating cognition. In addition many people with Lewy body dementia experience visual hallucinations, delusions and depression. Medications to treat symptoms are available, but there is no medication developed specifically for Lewy body dementia. The medications for Alzheimer’s disease may be initiated by your physician.

Or, from Neurology Now:

Lewy body dementia (LBD) is characterized by dementia plus two or more of the following features: parkinsonism; recurrent fully formed visual hallucinations; fluctuations in cognition and/or arousal; and REM sleep behavior disorder (RBD).
The parkinsonian features include less facial animation, a stooped posture and shuffling gait, and slowness of movement. Tremor, an unintentional to-and-fro movement, may also be present. The hallucinations can involve vivid visions of people or animals, often with the same imagery/perceptions from day to day. Cognitive problems are usually notable in judgment, problem solving, complex decision-making, and multitasking, as well as in visuospatial functions (required for activities such as driving). Memory may or may not be impaired.
Sleep disorders may cause problems with cognition and arousal as well as excessive daytime sleepiness. RBD refers to the tendency for people to act out their dreams. During normal REM sleep, our brains are active but most of the muscles in our bodies are still. But in RBD, the muscles are abnormally active, and injuries such as bruising, pulled hair, and even fractured bones can occur. The dreams often have a nightmare quality, with the person being chased or attacked.
These features contrast with other common dementia syndromes. In Alzheimer's disease, forgetting the details of recent events and upcoming appointments is the prominent early feature. Parkinsonism and hallucinations occur late in the disease if at all, and RBD is extremely rare. Frontotemporal dementia is manifested by marked changes in personality and behavior and/or language, whereas memory and visuospatial functioning tend to be minimally affected. Parkinsonism and visual hallucinations are uncommon in frontotemporal dementia, and RBD is also rare.

See also this article originally from Mayo Clinic:

http://www.cnn.com/HEALTH/library/AZ/00003.html

Or:

http://www.neurology.org/cgi/content/full/65/12/E26

I know it can be extremely difficult to differentiate between Lewy bodies and AD. My mother was diagnosed with AD, but my father -- a doctor, GP -- finally became convinced she had Lewy bodies. Note: some patients with Lewy body apparently are more likely to suffer delusions and hallucinations if given namenda.

Some researchers are evaluating a possible correlation between excessive daytime sleepiness in AD patients and the development of other Parkinson symptoms, such as shuffling. Maybe that's what I vaguely recall hearing about.


Other articles, including the following one from the University of California, suggests that some patients diagnosed with AD who have a shuffling gate, poor bladder control, and short-term memory loss may actually have normal pressure hydrocephalus (NPH):

http://www.universityofcalifornia.edu/news/article/8787

NPH is treatable. Most of the people who actually have NPH but are misdiagnosed as having AD were never given an MRI or CT scan of the brain.

We have an AD Dx, and we have had shuffling for some time now...probably since about stage 5. My take on it is that she is afraid to misstep. Here's how my theory on the 'why' of shuffling:

As you may know, one of the ways to keep an AD patient from leaving a room is to paint the door the same color as the wall, or put a black rectangle in front of the door. One of the reason they are afraid to get in the bathtub is they can no longer see the bottom, so we put in bubble bath or bath salts to help that. Food on a white or cream colored plate gets eaten less than food on a brightly colored plate. It's all a matter of perception: depth percetion, not recognizing what is there, etc.

So if you were blindfolded and told to walk, you would start to shuffle to 'feel' out with your feet before you bumped into something. Without adequate perception abilities, they feel the need to shuffle.

I thought it was a physical thing until I found out that if it were too cold or too hot or too windy out, all I had to do was say, "Come on, hurry! It's so cold out!" and she would get GOING! I mean, one minute we are shuffing along, and the next she's hotfooting it into the house. So it wasn't always physical, at least not all of the time.

The things we learn by observation. We should get honorary PhD's for our research...

Or we'd be out somewhere shopping and she'd want to go home. Shuffle shuffle, until I finally said, "Ok, let's go on home." Straight to the door, nice and brisk!

LOL
yhc

I agree with Trisinger's analysis. My DW shuffles along when she is walking behind me. If I take her hand and say "let's go", she is right with me. Last Fall she and I took a walk in our woods, something we have done many times. She seemed to be having trouble walking and fell twice. We have not been in the woods since. I think it is related to her vision, which is made worse by having cataracts.

I believe too that some of these diagnostic symptoms are interrelated and maybe there is a dementia that has some of all the listed above. i have thought DH had LBD from symptoms but dr say AD/VD combo. like trisinger says shuffling isnt a real symptom per say in our case, but an action to overcome balance or lack of perception sometimes. other times when hes pacing its almost like hes slow jogging hes going so fast. my DH does have very vivid hallucinations and persons/pets etc from the beginning stages. there may be separate symptoms DR can associate with one particular dementia but i do think its possible to overlap some of them. and yes its like we have our own 'clincial trials' going on here everyday. too bad someone doesnt write and document all the noticeable similarities for science to profit from! divvi

Hildann, how very interesting. I do wonder why music can have such a powerful impact on people.

Wheatleygirl, The walking slowly & behind me all the time, was the main reason I started this discussion. I always think others probably think I am ignoring him. He doesn't really shuffle when he walks, just slower than normal & kind of stiff legged. If I slow down, he slows down. That is a good thought, maybe he needs to follow me to feel secure.

I just got a phone call from one of the two men who took my husband out to an all male friend lunch this week. The lunch went well. He couldn't contribute to the conversation, but it went well anyway. And my husband who couldn't tell me what he had eaten did tell me he enjoyed it.

I asked about him taking part in the local hiking group since he is doing 2 hour "hikes" and what I got was confirmation that his walking is noticeably slow even when he is with someone other than me. He stopped going on those hikes before he was diagnosed and now I know why. He couldn't keep up. I haven't seen him walking when he is toally alone, so I don't know if he is fast or slow even then. Quite interesting.

Well, your puppy may not be learning to heel, but maybe your husband is ...

andy
Thanks for reposting the above. I found it very interesting as my dh showed symptoms of both Lewey Body and FTD @ dx. He will not walk with me and is getting further and further behind NOW even though I am going slower than before. He will not hold my hand either. I think I will try the music. He could never dance so guess he might not be able to follow the "beat" ha!
I will start watching to see if holding something will improve his gait.
This board is the absolute best for GOOD information.
Sweet Pea

Mine is so very slow also; and he can hardly pick up his right foot/leg, so stumbles a lot and has taken a few falls. He is using a cane more, and that helps some, but I never let him walk outside without me being right there with him. I know he has arthritis in his extremities and that contributes, but I also think his brain doesn't tell him to pick up his feet!

bak, I know what ya mean, suspicious indeed ;-)

i am thinking about getting a light weight wheelchair for DH, he still walks but is very slow and will not hold onto the cart a the stores to stay with me . of course he does not want to use one i tried my best a the last outing to get him to use one. i don't want to take his walking away from him but would it not be ok just for store outings that i have to take him with me on. no sure what the dr would say about ordering one through the insurance since he can still walk.

FD was diagnosed recently with vascular dementia. He started standing/walking very stooped over as early as last summer. It is actually difficult to button his shirt collar when he wants a necktie for church. Today he was in his garden cleaning up for winter as he says. When he came in he had dirt all over his legs and backside. I asked what happened and he said he fell several times. The ground is soft from a recent rain so he wasn't hurt. I had not known of him falling before but it concerns me that a fall might come on not so soft ground. He doesn't exactly "shuffle" but his gait is sure different from what it has been normally. This is something I hadn't even thought about or known for that matter about this disease. I'm learning so much from this board.

Got Dr. to order a walker with wheels today. He seems to be able to handle it a lot better than having to pick up a regular one. He tended to just pick it up and walk with it. He pushed this one around quite easily and it kept him from bending in half. I made sure it was tall enough that he had to stand tall to use it. Also got Dr. to approve a handicapped sticker......yeah!