What Are the Best Exercises for Dementia Patients?

Being active and getting exercise helps us all feel better. Exercise is a tried and true way to promote health and emotional wellbeing in all—but for those living with dementia, exercise is an excellent tool to alleviate behavioral and psychological symptoms of dementia (BPSD) and keep the muscles, joints, and heart in good shape.

Whether in the early, middle, or late stages of dementia, there are exercises for everyone. The important thing is to find activities that are fun, suited to the patient’s needs, and safe for their unique abilities.

In this article, we will discuss the benefits of exercise for dementia patients, tips for getting started, and a variety of exercises that may be incorporated in a home or senior living environment.

Benefits of Exercise for Dementia Patients

Exercise is such a powerful tool. According to the Alzheimer’s Society, exercise may benefit those living with dementia by:

• Improving the health of the heart and blood vessels, which can in turn reduce the risk of hypertension and heart disease.
• Reducing the risk of some types of cancer, stroke, and type 2 diabetes.
• Improving physical fitness.
• Improving the ability to perform Activities of Daily Living (ADLs).
• Keeping the bones strong and reducing the risk of osteoporosis.
• Improving cognition.
• Improving balance and strength, thus reducing the risk of falls
• Improving sleep.
• Improving confidence, self-esteem, and mood.

Exercise for Dementia Patients: Getting Started

When looking to incorporate exercise for dementia patients, it is important to choose activities that are enjoyable, sustainable, and tailored to the patient’s abilities. Understanding the abilities and unique interests of the patient can help you choose fun, yet appropriate and safe activities. Try to draw inspiration from their past experiences. You may consider their former lifestyle, hobbies, recreational activities, social interests, work history, and travel experience. 

Often, people living with dementia have “good” and “bad” times throughout the day. Their mood and functioning may be better early on in the day and poorer in the late afternoon (sundowning). Try to schedule activities in accordance with the times of day when the patient is at their best.

How you communicate with dementia patients during activities matters, too. Focus on one thing at a time and communicate one instruction at a time. Remember to check for understanding and assess body language to make sure they are not overwhelmed and are enjoying themselves. 

Dementia affects everyone differently, and consequently, each patient’s abilities may be different. They may also be living with other conditions that may limit their exercise abilities. Patients living with dementia who may have not exercised for a long period of time or may have health issues, such as heart problems, hypertension, frequent falls, dizziness or fainting, and bone or joint issues. Before beginning any new exercise or physical activity, always speak to a general practitioner or relevant healthcare professional.

Types of Exercise for Dementia Patients

Depending on the stage of dementia the patient is in, patients may struggle to perform exercises on their own or may have difficulty remembering sequencing. Consider joining in or leading the exercise to remove the pressure of having to remember what to do. Allowing patients to mimic your actions can remove the stress and frustration and allow them to fully immerse in the activity. Plus, working out with a friend is always better! 

Gentle Exercises for Dementia Patients

These gentle exercises are examples of activities a late-stage dementia patient may be able to perform:

• Balance and posture: Balance is needed for several ADLs, including bathing, transferring, and dressing. To help, patients can practice balancing in a standing position, unsupported, or with support to hold if needed. 
• Muscle strength: Muscle strength and mobility are needed for several ADLs, including using the toilet, bathing, and transferring. The sit-to-stand exercise is a great way to work on lower body muscle strength. Sitting in an unsupported position for a few minutes each day can help strengthen the abdominal and back muscles and can be used to support posture.
• Flexibility: Stiff muscles can cause additional challenges with movement and may cause pain. Regularly stretching, either on a bed or soft surface on the floor, can help relieve tight muscles and improve flexibility.

Moderate Exercises for Dementia Patients

These moderate exercises are examples of activities a middle-stage dementia patient may be able to perform:

• Seated exercises: Local community centers often provide a range of organized exercises, including seated exercise programs. Some examples of seated exercises include marching, rotating the body from side to side, bicycling the legs, making circles with the arms, raising the opposite arm and leg, and raising the heels and toes.
• Tai chi and qigong: Tai chi and qigong are light forms of Chinese martial arts that combine slow, deliberate movements, breathing exercises, and meditation. Both are great options for working on balance, stability, and alignment.

Gardening: Gardening allows patients to enjoy nature and the outdoors. It can be easily tailored to the patient’s unique abilities. More gentle gardening activities can include weeding, pruning, and planting, while more strenuous activities may include raking leaves and mowing the lawn.

Advanced Exercises for Dementia Patients

These advanced exercises are examples of activities an early-stage dementia patient may be able to perform:

• Dancing: Dancing may reduce anxiety and agitation and improve quality of life and overall well-being while allowing patients to express themselves in new, fun ways. 
• Fitness classes: Many senior living facilities and local community centers offer exercise classes specifically designed for people living with dementia.
• Swimming and water activities: Supervised swimming is a great activity for those with dementia. The sensations that come with being in and moving in the water can be relaxing and comforting. Several studies also suggest that swimming may improve balance and reduce the risk of falls in dementia patients.

Assessing The Impact of Exercise on ADLs

To assess the impact of exercise for dementia patients on ADLs, whether in a senior living or home environment, caregivers and loved ones can incorporate routine assessments of neurocognitive function. This provides insight into the effects of exercise on the ability to complete ADLs and is also a great tool to understand patients’ changing needs over time to inform care needs.