Does Alzheimer's Disease Affect Your Ability to Walk?

Alzheimer's Disease Can Sometimes Impact Ability to Walk
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Historically, the emphasis and study of the symptoms of Alzheimer's disease focused almost solely on cognitive issues, looking at what type of impairments developed- such as memory, language and behavior- and what interventions and treatments were most helpful.

More recently, however, there is an increasing awareness of the physical affects of Alzheimer's disease, especially on one's gait in walking.

What Is Gait?

Gait refers to the motion and stride of walking. For example, a person who has Parkinson's disease may be described as having a shuffling gait where his steps are hesitant and his feet move along the ground in almost a dragging manner.

How Are Gait and Walking Affected by Alzheimer's?

In the early stages of Alzheimer's, the ability to walk often appears to be fairly well-preserved. In fact, some people with early stage dementia can walk for miles each day. However, research has been discovering that others with early stage dementia do have some changes in their gait.

One study conducted by Mayo Clinic involved more than 1300 participants. Their cognitive ability was measured over the course of 15 months, as well as their stride and gait in walking. The researchers found that participants who experienced a decline in walking ability were more likely to experience a significant decline in cognitive functioning.

Executive Functioning Changes

Executive functioning includes the ability to plan, prioritize, apply knowledge and make decisions. A decline in executive functioning is one symptom of Alzheimer's disease.

Researchers have noticed that some people with early dementia, when asked to simultaneously perform a task such as tapping a finger and walking, or counting backward and walking, (abilities that require executive functioning) show a decline in gait and/or speed of walking.

A second study found that poorer performance on the Trail Making Tests A & B, a common test that measures cognitive ability and more specifically executive functioning, was shown to be predictive of a decline in walking and mobility.

Another study published in Physical Therapy noted that slower walking speed was associated with poorer performances on both the Trail Making Tests and the Stroop test, another cognitive tool that assesses executive function.

Next Steps

With multiple research studies documenting a change in the ability to walk correlating with a decline in cognition, how does this impact the way we approach Alzheimer's disease and other types of dementia?

Watch your loved one walk. If you notice a decline in the stride or speed in walking that's not connected to a clear cause (such as arthritis or a history of a stroke), observe if there are any cognitive changes present. Consider asking a physician or psychologist to evaluate his cognitive functioning so that early detection and treatment can be provided.

Additionally, if your family member's primary concern is her memory and she's being evaluated for a possible diagnosis of Alzheimer's disease, be sure to report to the physician any decline in stride or speed in walking so that this can be taken into account in the evaluation.

Finally, remember that some medications or combinations of medications can affect both a person's gait and balance as well as their cognitive functioning, so don't hesitate to ask the doctor about the medicines your loved one receives and their side effects.


Dementia and Geriatric Cognitive Disorders. Vol. 36, No. 1-2, 2013. The Relationship between Executive Function and Falls and Gait Abnormalities in Older Adults: A Systematic Review.

Journal of the American Geriatrics Society. Trail making test predicts physical impairment and mortality in older persons. 2010 April 58(4); 719-723.

Mayo Clinic. Slow Gait Tied to Higher Risk of Cognitive Decline. July 18, 2012.

Neuropsychiatric Disease and Treatment. 2008 February; 4(1): 155–160. Gait analysis in demented subjects: Interests and perspectives.

Physical Therapy. 2011 Aug ;91 (8):1198-207. Associations between physical performance and executive function in older adults with mild cognitive impairment: gait speed and the timed "up & go" test.

Schwfeizer Archiv Fur Neurologie und Psychiatrie. 2010;161(6):195–9. Gait and cognition: the impact of executive function.

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