What should we be recommending exercise and dementia?

Oct 21, 2025 4 min read •

Dementia Care Healthy Aging Physical Activity

Studies suggest that even modest physical activity can significantly lower dementia risk. So, what should we be recommending exercise and dementia for optimal brain and body health? Experts advise a personalized, multi-component approach to improve cognitive and physical well-being.

Quick Summary

Expert recommendations for exercise and dementia emphasize safe, enjoyable, and consistent routines incorporating aerobic, strength, and balance training. Programs should be adapted to the individual's ability, focusing on engagement and overall health benefits to improve quality of life.

Key Points

Personalize the Program: Tailor the exercise routine to the individual's interests, abilities, and current fitness level for maximum engagement and enjoyment.
Start Slow, Stay Consistent: Begin with short, manageable sessions and build up gradually. Consistency is more important than high intensity.
Combine Exercise Types: Recommend a multicomponent program that includes aerobic, strength, and balance training to address multiple health aspects.
Prioritize Safety: Conduct a medical check-up before starting, ensure proper supervision, and adapt exercises as the disease progresses to prevent injuries.
Incorporate Everyday Activities: Simple tasks like gardening, housework, or taking short walks can count toward daily activity goals and provide a sense of purpose.
Focus on Enjoyment: The goal is to promote positive feelings and engagement in the present moment, even if the person doesn't remember the specific activity later.

The Proven Power of Movement

Exercise is one of the most effective non-pharmaceutical interventions for managing cognitive decline and improving the overall quality of life for individuals with dementia. The benefits extend far beyond physical fitness, influencing mental health, behavior, and social engagement. Regular physical activity can help manage behavioral symptoms, reduce anxiety and depression, and improve sleep patterns, which are all common challenges associated with dementia.

Evidence shows that being physically active promotes better brain health. It increases blood flow to the brain, reduces inflammation, and can promote neuroplasticity—the brain’s ability to reorganize and form new neural connections. These physiological changes can help to slow the rate of cognitive decline and potentially improve specific brain functions like memory and thinking speed. Engaging in regular movement also helps to maintain physical functionality, delaying the need for higher levels of care and enabling individuals to retain independence for longer.

Multicomponent Exercise Programs

Instead of focusing on a single type of exercise, a multicomponent program is often the most beneficial. It combines several categories of exercise to provide comprehensive physical and mental benefits. This approach ensures that individuals work on multiple aspects of their health simultaneously.

Core Components of a Comprehensive Program

Aerobic Activity: This is the cornerstone of brain health exercise. Aerobic activities get the heart rate up and increase blood flow. The World Health Organization recommends at least 150 minutes of moderate-intensity aerobic physical activity per week for older adults.
- Brisk walking
- Swimming or water aerobics
- Dancing
- Light cycling
- Tai chi
Muscle-Strengthening Activities: These are important for maintaining muscle mass and strength, which improves mobility and reduces the risk of falls. They should be performed on at least two non-consecutive days per week.
- Using resistance bands
- Lifting light weights (e.g., canned goods)
- Bodyweight exercises (e.g., chair squats)
Balance Training: As dementia progresses, balance and coordination can decline, increasing fall risk. Specific exercises can help improve stability.
- Tai chi
- Weight shifts while standing
- Standing on one foot (with support)
Flexibility Exercises: Gentle stretching can improve range of motion and prevent injury. It is a calming component often incorporated into warm-ups and cool-downs.

Personalizing the Exercise Routine

For exercise and dementia, the best recommendation is a program that the individual enjoys and can sustain over time. A personalized approach, guided by a healthcare provider or physical therapist, is key. It involves understanding the person’s interests and current abilities to create a routine that is motivating and safe.

Practical Strategies for Success

Start Small: For those new to exercise or with advanced dementia, start with short sessions of 10–15 minutes and gradually increase the duration. The key is consistency, not intensity.
Incorporate Familiarity: Use activities from the person's past. A former gardener may enjoy light weeding, while a social dancer might thrive in a group dance class.
Engage the Senses: Pair exercise with sensory experiences. Walking outside to feel the sun or listening to favorite music while dancing can increase enjoyment and engagement.
Use Everyday Activities: Many everyday chores can be repurposed as exercise. Housework, gardening, and walking the dog all contribute to the weekly activity goal.
Focus on the Moment: A person with dementia may not remember the workout, but they can still enjoy the positive feelings it creates. Focus on the pleasure of the activity in the present moment.
Use Visual Cues: For those with memory loss, demonstrating the exercise and using visual cues can be more effective than verbal instructions. Breaking down movements into simple, manageable steps is also helpful.

Safety First: Essential Precautions

Safety is paramount when recommending exercise for individuals with dementia. A comprehensive medical check-up is a critical first step to ensure there are no underlying conditions that might limit activity.

Key Safety Guidelines

Medical Consultation: Always consult a doctor or physical therapist before starting a new exercise program. This helps tailor the routine to the person's specific health needs and stage of dementia.
Supervision: Depending on the stage of dementia, supervision may be necessary, especially for outdoor activities, to prevent wandering or falls.
Timing: Consider the person's best time of day. For some, morning activity is best, while for others, a late afternoon walk can help with restlessness.
Hydration: Ensure the person drinks plenty of water before, during, and after exercise, as they may not remember to do so themselves.
Listen to Their Body: Pay close attention to verbal and non-verbal cues. If they appear dizzy, faint, or in pain, stop the activity immediately.
Appropriate Environment: Choose a safe, clutter-free space for indoor exercises. For outdoor walks, stick to familiar, low-traffic routes.

Comparing Exercise Intensity and Benefits


Intensity Level	Example Activities	Cognitive Benefit	Physical Benefit
Light	Gentle stretching, seated exercises, housework	May improve processing speed	Improves flexibility, reduces sedentary time
Moderate	Brisk walking, dancing, gardening	Improves memory, attention, executive function	Cardiovascular health, improved endurance
Vigorous	Jogging, fast cycling, advanced aerobics	Larger brain volume, potentially greater cognitive improvements	Significant cardiovascular benefits, weight management

Final Recommendations and Long-Term Outlook

For anyone involved in the care of a person with dementia, exercise is a powerful tool to maintain physical and cognitive health. The goal is to make physical activity a consistent, enjoyable part of their daily routine, adapted to their changing needs. By focusing on multi-component exercise, prioritizing safety, and personalizing the approach, caregivers and family members can help improve the person's overall quality of life and well-being. Ultimately, any movement is better than none, and it's never too late to start reaping the benefits.

For more detailed guidance on adapting exercise for people with dementia, including a list of seated exercises and other activity ideas, the Alzheimer's Society provides excellent resources.

Frequently Asked Questions

The best exercise is a multi-component program that includes aerobic activity (like brisk walking), strength training (using light weights), and balance exercises (like Tai chi). The key is to find activities the person enjoys and can do safely.

Recommendations generally align with standard guidelines, suggesting at least 150 minutes of moderate-intensity aerobic activity per week, plus strength-building on two days. For individuals with dementia, it is often best to break this into shorter, more frequent sessions (e.g., 10-15 minutes at a time).

Yes. Studies show that regular exercise, particularly aerobic exercise, can help slow the progression of cognitive decline and improve overall brain health. It increases blood flow to the brain and promotes beneficial cellular changes.

For individuals with advanced dementia, seated exercises are often the safest and most effective. Options include seated leg extensions, arm raises, and gentle stretches. Walking with supervision, even for short periods, is also beneficial.

Safety precautions include consulting a doctor, ensuring proper hydration, choosing a safe and clutter-free environment, and providing supervision, especially for outdoor activities. Always monitor for signs of pain or dizziness and adjust the activity level accordingly.

Yes, group exercises can be highly beneficial. They provide a valuable social outlet, which combats isolation, and can enhance motivation. Activities like dance classes or supervised walking groups offer both physical and social engagement.

To make exercise more engaging, incorporate familiar and enjoyable activities, use music, and focus on simple, repeatable movements. Breaking down complex tasks into smaller steps and providing positive reinforcement can also help maintain interest.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.