What causes some older people to shuffle as they walk?

Dear Carol: My dad was never a fast walker, but lately he’s been shuffling along like the aging stereotypes. He has severe arthritis, so I know pain is a factor, but this is different than when he limps from an arthritis flare. When I told him that I’d noticed that lately he’s been shuffling as he walks, he said that he’s “getting older” and I need to expect changes. If age is the only reason for his shuffling, I’m OK with it, but this change seems rather extreme. – SL

Dear SL: How a person walks can indicate any number of health-related issues so it’s good that you noticed this change. In fact, doctors sometimes ask an older adult to walk for them so that they can note gait changes that might indicate problems. So, let’s look at some potential reasons for these changes:

Environment: You didn’t specify if your dad shuffled inside as well as outside, but if he only does so outside, remember any ice at all increases the fall risk, so you’ll see more shuffling in the wintertime. That’s self-preservation. Related to ice but inside buildings, if a floor is so highly polished that it looks slippery, an older person may automatically adjust their pace.

Joint challenges: As you suggested, arthritis and other joint ailments such as weak hip or knee muscles as well as foot pain can cause a change in gait. Related to this, of course, could be slower reaction times.

Balance: A reason less obvious to an observer but important, can be that the older person fears falling due to poor balance caused by physical deterioration. medication side effects or brain changes.

Vertigo: Another reason could be dizziness caused by Benign Paroxysmal Positional Vertigo. BPPV is a condition where the crystals within the ear canal that help us stay balanced float out of place. BPPV can happen at any age, but it’s more common in older adults. An ENT physician can usually diagnose and treat BPPV, as can many physical therapists. Interestingly, they test for it by looking for nystagmus (a type of movement) in your eye. On its own, BPPV isn’t serious, but it can interfere with daily life and even cause a fall, so for quality-of-life purposes, it’s good to seek treatment.

Footwear: Poor-fitting shoes can cause people to shuffle. If foot problems such as arthritic toes push people to change shoe sizes, it can take time to find the right fit.

Vision: Sometimes new glasses or better treatments for a vision-related disease may help.

Neurological: Gait changes can occur due to neurological problems, so a medical consultation is advisable.

SL, the key here is the word “change.” If someone has always had a shuffling walk, then perhaps there’s nothing to be concerned about. However, a change in someone’s gait should be investigated since it could be a sign of something more serious. For your dad, even if the cause is not serious, the doctor may have ideas that can improve his quality of life.