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The way you walk isn’t just coincidence

The way you walk is unique to you. Everybody walks a little differently, and your style of walking changes as you age. 

As you get older, you may walk slower and more cautiously than before. But if you notice that you or a loved one are having trouble getting around, shuffling your feet or especially falling, it could be a sign of something more serious.

“While your muscles control the way you walk, your brain is what’s working behind the scenes,” said neurologist Glen Finney, MD, director of Behavioral Neurology at Geisinger. “Your brain is responsible for both your movements and your balance. As a result, diseases that affect the brain, like vascular disease, normal pressure hydrocephalus, multiple sclerosis and Parkinson’s disease, can all make it difficult to walk.” 

The way you walk can give early warning signs of these diseases. If doctors notice anything abnormal about the way you walk, they can perform tests to help diagnose these disorders before other symptoms appear.

Brain vascular disease
Forgetting your car keys is common. Forgetting the name of a loved one may be a result of Alzheimer’s disease or the second leading cause of dementia: vascular dementia. 

Alzheimer’s is a condition that affects your memory and ability to think, but vascular disease can cause changes in many different tasks the brain performs, especially walking. Vascular disease is caused by damage to the blood vessels in the brain from issues like high blood pressure, high cholesterol, high blood sugar and smoking. Before or after memory problems become obvious from vascular disease, you may notice the way it affects your gait, or the way you walk.

“Vascular disease in the brain can cause people to walk slowly and cautiously,” said Dr. Finney, director of the Geisinger Memory and Cognition Program. “This is especially true when multitasking.”

While Alzheimer’s can’t be stopped, vascular disease can be, so it is important to find it and treat it as early as possible.

Normal pressure hydrocephalus
Many older adults have some problems with controlling their bladder, or with walking as well as they used to do. When combined with memory and thinking problems, it could be sign of extra fluid inside the brain, an uncommon condition called normal pressure hydrocephalus. It’s reversible if caught early.

“While pictures of the brain are needed to support the diagnosis of normal pressure hydrocephalus, it can be hard to tell if enlarged spaces called ventricles are larger because of extra fluid or because of shrinkage of the brain,” said Dr. Finney. “But normal pressure hydrocephalus often has a special type of walking problem that if seen early can help make the diagnosis soon enough to prevent permanent damage.”

The best chance of reversing the problems with walking, incontinence, and thinking is if normal pressure hydrocephalus is caught within 6 months of the first symptom, there is a chance for improvement or halting the disease.  

Multiple sclerosis
Multiple sclerosis (MS) is a disease where your immune system attacks myelin, the coating that protects the body’s nerve cells. This causes damage and scarring on the nerves within the brain and spine, which can interfere with the brain’s ability to send messages throughout the body.

“During a flare-up, people with MS may have difficulty walking and balancing, and they may even fall,” said Geisinger neurologist Douglas Nathanson, MD. “While there’s no cure for MS, studies show that exercises can be helpful for slowing the progression of the disease.”

In addition to trouble balancing, some other early signs of MS are tingling, numbness and vision problems. If you notice any of these problems, go to the doctor. Catching MS early can prevent it from worsening.

Parkinson’s disease
Parkinson’s disease is a neurological disorder that causes movement problems such as tremors, which usually start in one hand and move throughout the body. As it progresses, Parkinson’s can cause difficulty walking and balancing. Many people who get Parkinson’s develop a hunched posture and a shuffling step.

“While researchers aren’t sure what causes Parkinson’s disease, there are treatment and surgery options available,” said Dr. Nathanson. “These treatments don’t slow down the progression of the disease, but they do help ease the symptoms.”

The way you walk can be an indicator of whether you have the disease. If you notice that your movements are slow, your arms don’t swing when you walk or that you’re having difficulty balancing, you should talk to your doctor.

Parkinson’s disease and other brain diseases like Parkinson’s disease can also cause problems with memory and thinking either at the beginning of the disease or after.

Gait analysis
If you believe you or a loved one has Alzheimer’s, MS or Parkinson’s, your doctor may use a gait analysis to help see how the problem has changed your walking.

Gait analysis is a procedure to monitor the way you walk on a pad with motion and pressure sensors. With these devices, doctors can map your movements and find abnormalities. This lets them see if and how you’re shuffling or struggling to balance. If they believe you have signs of a neurological disease, they may recommend further testing.

Dr. Glen Finney and Dr. Douglas Nathanson are neurologists at Geisinger Wyoming Valley Medical Center in Wilkes-Barre. The Memory and Cognition Program offers support groups for patients and caregivers. To find a local, no-cost session, visit and search “support.” 
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