Patients & caregivers

It is often thought that the reduced ability to move is due to aging and is unrelated to dementia. Certainly, in the case of Alzheimer’s disease, the doctor or nurse never mentions it. There, the focus is mainly on memory and behavior. If movement is no longer as easy or if there is no cooperation when helping to dress or wash, this is sometimes translated as problem behavior or even aggression.

High muscle tension: paratonia

The high muscle tension is called paratonia. This high muscle tension is initially noticeable as an inability to relax and slowly changes over time and as the disease progresses into counter movements during movements by, for example, a carer. The inability to relax and move with the patient is also called Mitgehen or facilitory paratonia. The movement against movement is called Gegenhalten or oppositional paratonia.

How does paratonia arise?

We do not yet know exactly how paratonia arises. In general, with aging, the movements become slower but in Alzheimer’s disease, the slow movement is part of the disease. As far as is known, there are two causes of slower movement and higher muscle tension in people with dementia.

  1. The muscles become stiffer and tenser due to sugar-protein connections that occur more rapidly in Alzheimer’s disease. We do not know why this happens faster than in healthy elderly people. It causes extra connections to form in the muscles that tighten the muscle.
  2. There is also another cause: if someone else moves a patient with Alzheimer’s disease, for example, to wash or dress him, a kind of automatic protective reaction is set in motion, which means that the muscles will stop the movement. Only when the brain has given the signal ‘safe’ does the muscle tension ease a little (often by moving quietly in a calm/silent environment with reassuring explanations).