Benefits of exercise and physical activity

Information provided by Alzheimer’s Society, www.alzheimers.org.uk/.

Physical activity and exercise

Exercise and wellbeing

Exercise is beneficial for physical and mental health and may improve the quality of life for people in all stages of the condition. Physical activities are sometimes defined as those activities that increase your heart rate and cause you to breathe more deeply. This includes everyday activities such as walking, gardening, or dancing, as well as sports and exercises with the specific aim of improving fitness. This page explains why being physically active is important for people with dementia. It gives examples of suitable exercises and physical activities for people in different stages of the condition and suggests how much activity is appropriate.

Taking regular physical exercise is an important part of a healthy lifestyle and can help to maintain wellbeing. Physical activity creates valuable opportunities to socialize with others and can help improve and maintain a person’s independence. This is beneficial to both people with dementia and their carers. Engaging in physical activities can also improve self-esteem and mood, which in turn encourages more social engagement that may also contribute to wellbeing.
When is exercise not appropriate?

It is important to exercise only as much as your current physical condition allows. Over-exercising may be bad for your health.

If someone experiences pain or feels unwell while taking part, or after increasing their activity levels, they should stop the exercise and seek medical advice.

Benefits of exercise and physical activity

Benefits
These include:

improving the health of the heart and blood vessels, which can reduce the risk of high blood pressure and heart disease

reducing the risk of some types of cancer (particularly breast and colon cancer), stroke, and type 2 diabetes

improving physical fitness – maintaining strong muscles and flexible joints can help people maintain independence for longer

improving the ability to dress, clean, cook and perform other daily activities (as these may be performed more effectively if someone is fitter or more supple)

helping to keep bones strong and reducing the risk of osteoporosis (a disease that affects the bones, making them weak and more likely to break)

improving cognition – recent studies have shown that exercise may improve memory and slow down mental decline

improving sleep

providing opportunities for social interaction and reducing the feeling of isolation

reducing the risk of falls by improving strength and balance

improving confidence

increasing self-esteem

improving mood.

Exercise in the early to middle stages of dementia

Introduction

Local community or sports centers often provide a range of organized exercise and physical activity sessions, such as ball games, seated exercises, tai chi, music and dance, indoor bowls, or swimming. You may be able to use a personal budget, in the form of a direct payment from your local authority to pay for these. Some of these activities can be modified and carried out at home. Walking, gardening and housework are also good forms of everyday physical activity.

People in the early stages of dementia may experience no new difficulties in sports and other physical activities they enjoy. They ought to be encouraged to continue these activities where possible.
What is the right amount of activity in the early to middle stages of dementia?

There is no definitive answer to this question and the right amount of exercise will vary from person to person. The Department of Health recommends 150 minutes of moderately strenuous physical activity per week. This equates to 30 minutes of activity per day, for at least five days a week. This can be broken up into shorter sessions throughout the day, with each session lasting a minimum of 10 minutes. For example, it could be a 15-minute walk to the local shops, and then housework or gardening tasks in the afternoon.
Types of exercise for people with dementia
Below are some examples of the types of exercise that a person may perform. This is by no means an exhaustive list – any form of exercise can bring benefits.

Gardening

Gardening is a physical activity that provides an opportunity to get outdoors and is enjoyed by many people. The activity level can be varied to suit someone’s abilities. It could be something that requires less exertion like weeding or pruning, or more strenuous activity like raking or mowing grass. These activities may help strengthen the body’s muscles and improve breathing. Gardening can be an enjoyable activity for people at all stages of dementia.

Indoor bowling

Some people may retain their bowling skills or continue to participate in other ball games, and so may enjoy indoor carpet bowling. Some local leisure centers offer indoor bowling sessions, or sets can be purchased from toy or sports stores.

Dance

Dancing can range from tea dances and couple or group sessions to more improvised movement involving ribbons, balloons, or balls. Dancing can also be done in a seated position. This is a very social activity and an enjoyable way to participate in the exercise. It can increase strength and flexibility, help with staying steady and agile, and reduce stress.

Seated exercises

People with dementia can benefit from a regular program of seated exercise sessions at home or with a group at a local class. It is often a good idea to see these exercises demonstrated at least once by an instructor or on a video. These exercises are aimed at building or maintaining muscle strength and balance and are less strenuous than exercises in a standing position. They can be part of a developing program, with the number of repetitions of each exercise increasing over time. Some examples of seated exercises include:

marching

turning the upper body from side to side

raising the heels and toes

raising the arms towards the ceiling

raising the opposite arm and leg

bending the legs

clapping under the legs

bicycling the legs

making circles with the arms

practicing moving from sitting to standing.

Swimming

Swimming, under supervision, is a good activity for people with dementia. Many people find the sensation of being in the water soothing and calming. Some studies have also shown that swimming may improve balance and reduce the risk of falls in older people.

Tai chi/qigong

Tai chi and qigong are gentle forms of Chinese martial arts that combine simple physical movements and meditation, with the aim of improving balance and health. The movements concentrate on a series of integrated exercises. These forms of exercise focus on balance and stability, which are important in staying agile and may reduce the risk of falls.

Walking

Walking suits all abilities. It is free, does not need specialist equipment, and can be done anywhere. The distance and time spent walking can be varied to suit fitness levels. Some local leisure centers and other organizations arrange group walks, supported by a walk leader, of various lengths, so it can also be a social activity,

Exercise in the later stages of dementia

Introduction

Staying mobile may reduce the need for constant supervision from a caregiver. It may also minimize the need for certain adaptations, such as walk-in bathtubs or stair-lifts. Exercises can range from changing position from sitting to standing, walking a short distance into another room, to moving to sit in a different chair at each mealtime throughout the day.
What is the right amount of activity in the later stages of dementia?

There is no definitive answer to this question and the ideal amount of exercise will vary from person to person. People in the later stages of dementia should be encouraged to move about regularly and change chairs, for example when having a drink or a meal. There should be opportunities to sit unsupported (as far as possible) with supervision on a daily basis. A daily routine involving moving around the home can help to maintain muscle strength and joint flexibility.
Suggested exercises in the later stages of dementia
- When getting up or going to bed, shuffle along the edge of the bed, in the sitting position, from one end of the bed to the other. This helps exercise the muscles needed for standing up from a chair.
- Balance in a standing position. This can be done by holding on to support if necessary. This exercise helps with balance and posture and can form part of everyday activities, for example when showering or doing the washing up.
- Sit unsupported for a few minutes each day. This exercise helps to strengthen the stomach and back muscles used to support posture. This activity should always be carried out with someone else present as there is a risk of falling.
- Lie as flat as possible on the bed for 20-30 minutes each day, trying to reduce the gap between the curve of the back and the mattress. This allows for a good stretch, strengthens abdominal muscles, and gives the neck muscles a chance to relax.
- Stand up and move about regularly. Moving regularly helps to keep leg muscles strong and maintain a good balance.

Benefits of exercise and physical activity

Physical activity and exercise

Benefits of exercise and physical activity

Exercise in the early to middle stages of dementia

Exercise in the later stages of dementia

Memory Clinic Nurse Practitioner (NP)

Neuropsychiatrist

Memory Clinic Medical Social Worker

Neuropsychologist

Neurologist

Primary Physician/Geriatrician

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