Physical and Mental Exercises for Dementia

Staying physically and mentally active is one of the most useful things a person can do, both to lower the risk of dementia and to live well with it. Exercise is not a cure: it has not been shown to slow or stop dementia once someone has it. But it brings real benefits for mood, sleep, strength, balance and independence.

Physical activity and the risk of dementia

A lack of physical activity is one of the risk factors where the evidence is strong enough to show it raises the risk of dementia. An analysis combining 58 studies found that people who exercise regularly may be up to 20% less likely to develop dementia than those who don't.

The biggest gain comes from going from doing nothing to doing something. Staying active through middle age seems to have the strongest effect, but there is evidence that older people benefit too.

UK guidance for adults is at least 150 minutes of moderate activity a week (activity that raises your heart rate, such as brisk walking), or 75 minutes of vigorous activity. A mix of aerobic activity and strength-building activity is best. For other ways to protect your brain, see how to keep your brain healthy as you age.

Benefits of exercise for people with dementia

For someone already living with dementia, regular movement can help with:

• Strength, balance and coordination, which lowers the risk of falls and helps with everyday tasks like dressing and cooking.
• Heart and blood vessel health, reducing the risk of high blood pressure, stroke and type 2 diabetes.
• Sleep and energy levels.
• Mood. Exercise can ease symptoms of depression and build confidence.
• Social contact. Group activities help a person keep their sense of identity and avoid isolation.
• Some aspects of thinking. Some studies suggest exercise can improve focus and attention.

Even short periods of light activity are better than none.

Exercise ideas for different stages

• Early stage: walking, swimming, cycling, dancing, gardening, gym classes, tai chi or yoga. Many people can carry on with the sports and activities they already enjoy.
• Middle stage: shorter walks with a companion, seated exercise classes, gentle dancing to familiar music, and household tasks such as folding laundry or sweeping.
• Later stage: chair-based movements, stretching, passing a ball, and simply standing or walking a few steps with support to maintain strength.

Check with a GP before starting a new exercise programme, especially if the person has heart problems, joint pain or a history of falls. Choose activities the person enjoys, as that is what keeps them going.

Mental stimulation and cognitive therapies

Cognitive stimulation therapy (CST)

Cognitive stimulation therapy is the best-evidenced non-drug treatment for dementia. It usually runs as a group programme of around 14 themed sessions, with activities designed to exercise memory, problem-solving and language. NICE recommends it for people with mild to moderate dementia, and studies show it can improve thinking skills and wellbeing. Ask a GP or memory service whether CST groups run locally.

Brain training and puzzles

Observational studies show that people who do mentally stimulating activities in middle age and later life tend to have a lower risk of cognitive decline and dementia. But this doesn't prove the activities themselves are responsible.

Brain training games make you better at the specific tasks you practise, but there is no strong evidence that they prevent dementia. Activities that combine thinking with social contact, such as quizzes, card games, music groups and conversation, are often more valuable than solo puzzles.

Everyday activities that keep the mind engaged

• Reminiscence: looking through photos, talking about the past, listening to music from earlier years
• Reading, crosswords, word searches or jigsaws at a suitable level
• Arts and crafts, painting, knitting or baking
• Gardening or caring for plants
• Joining a memory café or day centre

For more ideas, see activities to keep the mind active for those with dementia.

Key points

• Regular physical activity lowers the risk of developing dementia, and it's never too late to start.
• For people with dementia, exercise improves wellbeing, strength and mood, though it doesn't stop the condition progressing.
• Cognitive stimulation therapy is recommended for mild to moderate dementia.
• Choose activities the person enjoys, and adapt them as needs change.