Corticobasal Degeneration (CBD)

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• Caregiving Challenges
• Strategies for Coping
• Safety and Environment

Caregiving Challenges
CBD has a profound effect on movement. People with CBD may experience tremor, myoclonus (sudden, jerky movements), dystonia (involuntary stiffening or contraction of an affected limb), and apraxia (inability to make the affected limb follow commands). Other symptoms include rigidity, slowed movements, and difficulty expressing speech. Some people experience an alien hand/limb phenomena in which the affected limb moves involuntarily. For example, some people after grasping an object will have difficulty letting it go. These changes impact the person’s ability to manage day to day tasks, such as dressing and walking.

Cognitive changes may include short term memory loss and difficulty with complex planning and organization. The person with CBD may exhibit language difficulties and have trouble with speech expression and finding the right word. It is not uncommon for people with CBD to suffer from depression.

Strategies for Coping
Certain medications may be helpful in diminishing the effects of tremor, myoclonus and rigidity. Other medications may be helpful for mood.

Physical therapy exercises may be useful to maintain mobility and range of motion of stiff joints, as well help with mood. An occupational therapist may be helpful in evaluating for adaptive and assistive equipment.

Exercise is recommended to increase strength and flexibility. People may prefer to work with a physical therapist or personal trainer. A physical therapist can evaluate the need for assistive devices such as canes or walkers.

A speech therapist can teach safer swallowing techniques to help prevent problems with choking and aspiration. Foods can be prepared in a way to minimize choking and aspiration. For example, cutting food into small pieces and drinking thick liquids can be helpful for some people.

The physical needs involved in caring for a person with CBD can be tremendous. It may be necessary to ask for help from family or friends or to hire someone to help with caregiving tasks. It is vital for the family caregiver to take care of their own physical and emotional health.

Safety and Environment
Home safety can be fostered by keeping pathways clear of objects such as low furniture, cords and area rugs that are difficult to see without looking down. An occupational therapist can perform a home safety check to make recommendations for assistive equipment and modifications.

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