Alzheimer’s and Bicycling

I bought Barbara a 3-wheel  bike a couple of years ago so we could once again tour the neighborhood together.  On any day I can say, “Let’s take a bike ride” and she’s ready to go. 

HomeCyclists Equipment News Resources Stories  July 20th, 2008

The challenges of Alzheimer’s and bicycling
When we think of cycling and limitations, we often consider the physical limitations of riders. We rarely consider conditions such as Alzheimer’s Disease.

It is widely known that Alzheimer’s Disease (AD) affects the memory of those afflicted, but it is not commonly known that as AD progresses, functions of balance and movement can be affected. These present an interesting challenge for those wishing to cycle in the midst of AD.

As with most issues of balance, we look to the recumbent tricycle as the logical solution. Recumbent tricycles (and quadcycles) remove the dependency on rider balance that bicycles require. AD patients suffering from physical imbalance certainly can benefit from a trike, but there’s a unique issue that comes into play.

AD sufferers might not remember how to ride a bike. The old adage that “once you learn, you never forget” does not apply here. Once seated upon a bike or trike, a person with AD might find that they no longer understand the basic mechanics of cycling. While it might be easy enough to quickly retrain them on pedaling, the complexities of shifting are not so easily retained.

There are three ways to address this. First, use a trike that uses a single gear with a freewheel. There’s no shifting involved. Second, invest in an automatic transmission system. Shifting will happen without requiring operator intervention. Third (and likely easiest), shift into a moderate gear combination such as the middle ring at the front and the middle cog in the rear, and then tape the shifters into place so that they can’t be adjusted.

That third option sounds simplistic, but it is an actual solution used by a man for his wife with AD. Until my conversation with him, I had not really considered the impact of AD on bicycling.

A diagnosis of AD does not mean that a support family should take away a bike, replace it with a trike, and seize up the shifters. Take things one step at a time as the disease progresses, and make changes only as the symptoms of progression demand them.

If you find yourself at that point and are considering a move to a trike, try to avoid configurations that will be wholly alien to the rider. Tadpole trikes in particular will be sufficiently unfamiliar as to introduce further confusion. Look instead to delta trikes with over seat steering, perhaps along the lines of a chopper bar. If necessary, a trike could be modified for a coaster brake if the rider is unable to remember to use the available brake levers.

The primary requirement will always be patience. If you’re working with a patient or loved one with Alzheimer’s, take the time to determine whether or not they want to continue riding. Take the time to determine what levels of cycling they can still process. And take the time to find a solution that fits them best. The point of putting an Alzheimer’s sufferer to pedals is to enhance their quality of life, not to frustrate them further.

It may very well be that, in time, they will no longer remember the fun they had getting out for a few rides. But while they can still ride, they’ll at least experience joy those days.