Exam 36 · 第36回 · 認知症の理解 (Understanding Dementia)
Question 42 問42
レビー小体型認知症（dementia with Lewy bodies）にみられる歩行障害として，最も適切なものを1つ選びなさい。
- しばらく歩くと足に痛みを感じて，休みながら歩く。
- 最初の一歩が踏み出しにくく，小刻みに歩く。
- 動きがぎこちなく，酔っぱらったように歩く。
- 下肢は伸展し，つま先を引きずるように歩く。
- 歩くごとに骨盤が傾き，腰を左右に振って歩く。
Translation
Among the following, choose the 1 option that is the most appropriate gait disorder (歩行障害) seen in dementia with Lewy bodies.
- Feeling pain in the legs after walking for a while, and walking with rest breaks.
- Having difficulty taking the first step, and walking with short shuffling steps.
- Moving clumsily, walking as if drunk.
- The legs are extended straight, and the person drags the toes while walking.
- The pelvis tilts with every step, and the person sways the hips from side to side while walking.
Show answer and explanation
Answer: 2
Why 2 is correct
Dementia with Lewy bodies is one of the types of dementia, and it is characterized by parkinsonism (パーキンソン症状). Because of this, a person has trouble taking the first step (freezing of gait) and walks with short, shuffling steps.
Why 1 is wrong
Walking that stops because of leg pain after a while is called intermittent claudication. It is seen in diseases where the leg blood vessels narrow, or in lumbar spinal canal stenosis.
Why 3 is wrong
Unsteady, drunk-like walking is called ataxic gait. It is seen with damage to the cerebellum.
Why 4 is wrong
Walking with the legs extended and the toes dragging is called spastic gait. It is seen in conditions where the muscles become stiff, such as after a stroke or with cerebral palsy.
Why 5 is wrong
Walking where the pelvis tilts and the hips sway from side to side is called waddling gait. It is seen with hip joint disorders or muscular dystrophy, when the muscles around the hips have weakened.
Key point
In dementia with Lewy bodies (レビー小体型認知症), the first step is hard to take and the person walks with short steps (小刻み).
Key terms
- レビー小体型認知症
- One of the types of dementia. It is characterized by visual hallucinations, parkinsonism, and day-to-day fluctuation in condition.
- 歩行障害
- Difficulty walking normally. The pattern of walking differs depending on the cause.
- 小刻み
- Walking with very short steps, in a shuffling way.
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Exams 36–38, all 13 subjects, with furigana and an English explanation of every choice. The subject 「認知症の理解」 is free.