Aberrant Motor Behavior in Dementia

Clinical Characteristics and Evaluation

The American Academy of Neurology suggests that patients with Dementia with Lewy Bodies (DCL) present with spontaneous parkinsonian motor features, cognitive fluctuations, and recurrent visual hallucinations as part of their clinical syndrome 1
The evaluation of motor function should include validated UPDRS scales and a falls survey, as falls in DCL are associated with substantial morbidity and mortality 2
The assessment of sensory and motor function, particularly vision, hearing, gait, and balance, is crucial, as these problems coexist with cognitive decline and substantially increase the risk of falls 3
Hearing loss is a known risk factor for dementia and can be potentially reversible 3
Gait and balance problems may signal Parkinson's disease spectrum disorders (DCL or Parkinson's disease dementia), vascular cognitive decline, or frontotemporal lobar degeneration-related diseases 3

The American Geriatrics Society recommends that physical therapy assessment and treatment for gait and balance, occupational therapy home assessment, and safety evaluation can improve motor function or balance 3
The use of assistive devices, night lights, grab bars in showers, and removal of tripping hazards is recommended 3
Early and sustained interventions with exercises are beneficial 3

The International Parkinson and Movement Disorder Society suggests differentiating aberrant motor behavior from other movement disorders, such as parkinsonism, dystonia, and functional neurological disorders, which can be more common in adults with certain conditions 5
Drug-induced parkinsonism should be differentiated from neurodegenerative parkinsonism 5
Hypocalcemia can induce or worsen movement disorders 5