It was my son’s birthday recently so we met up with my daughter and her boyfriend for lunch. I took my crochet with me to keep my fingers busy in the uber. I have akathisia which makes it hard work sitting still. Of course it took time to order and for the food to arrive.
Dealing with social situations is incredibly frustrating. You would like to be all relaxed and have a good chat but I felt as if my brain was in the spin cycle and it was taking most of my energy just to keep on the chair . Going to the loo and having a little walk helped a bit .
Fortunately I had remembered my ipad so when I was having trouble speaking I could type out a sentence or question. And the waiter kindly took photos for us as I was shaking too much
We went for a walk afterwards and my gait mirrored my speech - like wading through mud.
Thank goodness for email…
Cognitive Changes in Parkinson’s Disease J.G.Goldman 2005 AMERICAN PARKINSON DISEASE ASSOCIATION
Attention and working memory: Attention is the ability to selectively focus on a particular part of one’s environment, often while ignoring competing stimuli. In PD, people may find it difficult to concentrate on a conversation, read a book, or talk to someone while walking
Dual tasking in Parkinson’s disease: Cognitive consequences while walking. Salazar R.D., Ren X, Ellis TD, Toraif N, Barthelemy OJ, Neargarder S, Cronin-Golomb A. Neuropsychology. 2017 Sep;31(6):613-623.
Beginning with the motor symptoms, PD-related gait abnormalities include slow walking speed, short strides, propulsion, retropulsion, shuffling steps, reduced or absent arm swing, and rigidity in trunk movements (with some individuals also experiencing freezing of gait).
Among the nonmotor symptoms, cognitive impairments are common in PD and interact with walking and other motor symptoms. Even early in the disease course, disruptions to frontal-striatal circuitry result in attentional and executive dysfunction.
Dual-tasking studies of PD have identified several deleterious changes in gait that are elicited by concurrent cognitive challenge (i.e., cognitive load), including slower walking speed, increased stride width, increased gait variability,
shorter step length, postural instability , more steps and increased cadence during turns,
and poorer bilateral inter-limb coordination .
Movement Automaticity and Dual-Tasking
Automatic movements are movements performed without directed attention, and they can even be complex movements with significant training.
Walking is typically automatic, and with training, activities such as typing or playing the piano can be automatic as well. During automatic movements, aspects such as speed and amplitude are selected without conscious thought.
Almost all PD patients, including those with well-controlled and non-troublesome motor symptoms, describe impairments in automaticity and dual-tasking.
Concurrent performance of cognitive and motor activities or multiple motor activities can be impaired, and activities such as talking while walking, listening while writing, and balancing carried objects while walking are usually described as more difficult, even in the early stages of the disease.
Patients with PD have to rely (to a much greater degree) on attention-focused motor control to complete motor tasks, which also contributes to the appearance of bradykinesia, as the amount of slowing seen in patients with PD when performing two movements simultaneously is greater than the sum of the reduction in speed seen with each individual movement.