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Dementia and contractures

Updated: Aug 1, 2023

Dementia is a complex neurodegenerative condition characterised by the progressive decline of cognitive function and memory. This condition affects various regions of the brain, leading to impairments in thinking, reasoning, behaviour, and the ability to carry out daily activities. One physical manifestation commonly associated with dementia is the development of contractures.

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Memory and muscle challenges coincide in Dementia and Contractures.

So, what exactly is a contracture?


A contracture is a condition characterised by the permanent shortening and tightening of muscles, tendons, and other soft tissues. This results in a loss of joint mobility and can lead to pain, discomfort, and limitations in overall functionality. Contractures can affect multiple joints in the body, including the fingers, wrists, elbows, shoulders, hips, knees, and ankles.


The relationship between dementia and contractures is multifactorial and involves a combination of neurological, physiological, and behavioural factors.


Let's delve into these factors in greater detail:


Neurological Factors:


Dementia affects the brain's control and coordination of muscle movements. As the disease progresses, motor function declines, leading to muscle weakness, reduced mobility, and impaired communication between the brain and muscles. These neurological changes contribute to muscle imbalances, increased tone (spasticity), and reduced range of motion, all of which play a role in the development of contractures.


Immobility and Inactivity:


People with dementia often experience a decline in physical activity and mobility. As cognitive function declines, individuals may become less motivated or able to engage in regular exercise or movement. Prolonged periods of immobility and inactivity can result in muscle disuse and atrophy. Weak muscles are more prone to contractures due to the loss of muscle length and flexibility.


Altered Sensation and Perception:


Dementia can affect sensory processing, including the perception of pain, touch, and joint position sense (proprioception). Some individuals with dementia may have difficulty recognizing and interpreting pain or discomfort signals from their bodies. As a result, they may not seek help or report early symptoms of contractures, allowing them to progress further.


Impaired Motor Planning and Execution:


Dementia affects the ability to plan and execute complex movements. Consequently, individuals may adopt abnormal movement patterns, postures, or body mechanics that place excessive stress on certain muscles and joints. Over time, these abnormal movement patterns can lead to muscle imbalances, joint misalignment, and the development of contractures.


Medications:


Certain medications commonly used to manage symptoms of dementia, such as antipsychotics or sedatives, can contribute to muscle weakness, decreased mobility, and an increased risk of contractures. These medications may have side effects that affect muscle tone, coordination, and overall physical function.


Reduced Environmental Stimulation:


People with dementia may spend prolonged periods in environments with limited opportunities for physical activity and stimulation. This lack of environmental stimulation can contribute to muscle deconditioning and further exacerbate the risk of developing contractures.


Understanding the relationship between dementia and contractures, as well as the nature of contractures themselves, is crucial for healthcare professionals, caregivers, and individuals affected by dementia. By addressing these factors, implementing preventive measures, and seeking appropriate interventions, it is possible to reduce the risk and impact of contractures, improve joint mobility, and enhance overall well-being.

Elderly lady in a wheelchair, concealing a precious flower, enjoying a peaceful moment of nature's beauty
Elderly lady in a wheelchair, concealing a precious flower

Dementia and Contractures: Strategies for Prevention and Management


Dementia and contractures are closely linked conditions that require proactive strategies for prevention and management. Contractures, characterised by the permanent shortening and tightening of muscles, tendons, and other soft tissues, result in a loss of joint mobility, discomfort, and functional limitations. Understanding the impact of dementia and contractures is crucial to develop effective strategies for care.


To address the challenges of contractures in individuals with dementia, consider the following strategies:


Range of Motion Exercises:


Regular and gentle range of motion exercises are crucial for individuals with dementia to maintain joint mobility, muscle length, and flexibility. These exercises, performed within the individual's pain tolerance and abilities, play a pivotal role in mitigating the risk of contractures. Caregivers or physical therapists can guide these exercises, which involve gentle movements to promote joint flexibility.


Environmental Modifications:


Creating a safe and stimulating environment is vital in encouraging physical activity and mobility for individuals with dementia and contractures. Adequate lighting, removal of obstacles, and the use of mobility aids contribute to a supportive environment that promotes movement. By optimising the physical surroundings, individuals with dementia can engage in functional tasks, reducing the likelihood of contractures.


Pain Management:


Proper assessment and management of pain are paramount in preventing and managing contractures in individuals with dementia. Regular evaluation of pain levels, as well as addressing underlying causes, is essential. Effective pain management reduces discomfort and hinders the progression of contractures.


Assistive Devices:


Utilising assistive devices, including splints, braces, or orthotics, can be beneficial for individuals with dementia and contractures. These devices aid in maintaining proper joint alignment, preventing muscle shortening, and providing support during functional activities. By incorporating assistive devices, individuals can reduce the risk of contractures and improve overall mobility.


Caregiver Education and Training:


Educating caregivers and healthcare professionals on the connection between dementia and contractures is vital for effective care. Understanding the impact of dementia on mobility and joint health enables caregivers to provide optimal support. Caregivers should receive training on proper body mechanics, positioning techniques, and the significance of regular movement and exercise for individuals with dementia and contractures. This knowledge empowers caregivers to reduce the incidence of contractures and enhance the well-being of individuals.


In conclusion, individuals with dementia and contractures face unique challenges that require comprehensive strategies for prevention and management. By implementing range of motion exercises, environmental modifications, effective pain management, utilising assistive devices, and providing caregiver education, the impact of contractures can be minimised. These strategies are crucial in ensuring the well-being and enhanced mobility of individuals with dementia and contractures. To know what a contracture is and understand its implications, it is important to recognise the connection between dementia and this condition.


Reach out to The Well Balanced Centre for Expert Dementia and Contracture Care

At The Well Balanced Centre, we specialise in offering top-notch care and treatments for various conditions, including personalised support for dementia and contractures. If you or a family member are dealing with dementia or contractures, don't hesitate to get in touch with us at 07852526916 or via email at hello@thewellbalancedcentre.co.uk


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