Does exercise help people living with dementia?

What does the research show?

A Cochrane review of exercise programmes for people with dementia found promising evidence that exercise may improve the ability to carry out activities of daily living, such as moving around, dressing and toileting. The same review found no evidence that exercise improved cognition, behavioural symptoms or depression, and it advised some caution in interpreting the results because the studies varied 1.

This is an important distinction. Exercise is not a treatment that restores memory, but it can help people keep the physical abilities they need for everyday life, which matters a great deal for independence and for the people who support them.

Why does staying active matter in dementia?

People living with dementia often become less active over time. Reduced activity leads to weaker muscles, stiffer joints, poorer balance and lower fitness, which in turn make walking, transfers and self-care harder. This decline can happen faster than the dementia itself would cause.

Staying active also provides structure to the day, opportunities for social contact and a sense of achievement. Many families find that regular activity is linked with better sleep and fewer periods of restlessness, although these effects vary between people.

Which types of exercise are suitable?

Walking, seated exercise, gentle strengthening with light weights or resistance bands, balance activities, dancing, gardening and household tasks all count. Activities that the person used to enjoy are often easier to start and continue, because familiar movements and music can be preserved even when other memories fade.

Global physical activity guidelines recommend a combination of aerobic, muscle-strengthening and balance activities for older adults, adjusted to ability 4. For people with dementia, simple instructions, demonstration, repetition and a consistent routine make participation easier.

Can exercise reduce falls in dementia?

People with dementia fall more often than other older adults, partly because of reduced attention, poor judgement of hazards, medicines and weakness. Exercise programmes that include balance and strength training reduce falls in older people living in the community 3.

For people with dementia, balance training should be supervised and adapted, and combined with other fall prevention measures such as good lighting, clear pathways, appropriate footwear and a review of medicines that cause drowsiness or dizziness.

How can carers help someone stay active?

Building activity into daily routines, such as walking to the shop, helping with washing up or folding laundry, can be more successful than formal exercise sessions. Keeping activities simple, breaking them into steps and giving one instruction at a time reduce confusion.

Choosing a time of day when the person is most alert, exercising together and focusing on enjoyment rather than performance help. Carers should watch for signs of pain, tiredness or distress, as the person may not report them clearly.

What does dementia guidance recommend?

UK dementia guidance emphasises supporting people to live well, including offering activities that promote well-being tailored to the person's preferences, and considering interventions to maintain physical function and independence 2.

Occupational therapists and physiotherapists can assess mobility, adapt the home and recommend safe activities. Group programmes designed for people with dementia and their carers can also provide social support.

When should exercise be approached with caution?

People with heart or lung conditions, dizziness on standing, recent falls, pain or significant frailty should have their exercise plan reviewed by a health professional. Sudden changes in ability, new confusion or unexplained drowsiness may signal infection or another medical problem and need assessment.

Wandering or getting lost is a concern for some people with dementia. Walking with a companion, using familiar routes and carrying identification help keep walking safe.

Frequently asked questions