Better health for people living
with dementia
Keeping physically active
Physical activity has many health benefits. People who are physically active feel stronger, sleep better, have better coordination and balance, and have a general sense of wellbeing.
Guidelines on physical activity apply to people living with dementia, and their carers too. There is a growing body of evidence that a person living with dementia can build strength and improve balance and mobility through physical activity and exercise.
For people living with dementia, exercise programs have also been shown to improve the performance of daily tasks such as dressing (1:p54). Exercise supports healthy brain function and some studies of people living with dementia have reported benefit to cognition and mood (1:p54). Exercise and physical activity can also improve cardiovascular health, help manage weight and reduce the risk of diabetes.
There are social and emotional benefits too, from getting out and meeting new people, to reducing stress, anxiety and depression. Physical activity may also reduce some of the behavioural and psychological symptoms of dementia.
Practice points
Physiotherapists:
- assess transfers, mobility, strength, balance and other fall risk factors
- develop individualised exercise programs to maintain or improve mobility, strength, balance and endurance
- help find types of physical activity that are both safe and enjoyable, such as dancing or Tai Chi
- recommend group exercise or other programs, such as a falls prevention program
- suggest an appropriate walking aid and provide training about how to use it safely
- assess range of movement, position sense and praxis
- assist in developing strategies to help manage identified impairments and maintain safety
- assess and treat musculoskeletal injuries and help manage pain
- aid recovery from surgery and other illnesses through rehabilitation
- help to manage other chronic diseases unrelated to dementia, such as lung andheart disease
- have a role in pain management.
Occupational therapists:
identify barriers to participation in physical activities and exercise
minimise risks and impediments to maximise active enjoyment of life
assess the home environment and prescribe modifications if needed
prescribe aids or equipment to allow engagement in physical activity and exercise
have a role in pain management.
Exercise physiologists:
- provide exercise programs to support people with the management of chronic disease.
Dietitians:
- provide advice on adequate nutrition to improve muscle strength, support physicalexercise, reduce the risk of falls and improve independence and wellbeing.
Podiatrists:
- assess foot problems6
- maintain foot health – toenails, bunions, corns and arthritic joints
- advise about appropriate footwear
- treat pain.
Ken's story
Within a few months of being diagnosed with dementia, Ken was having trouble walking and was using a walker.
A physiotherapist made six visits to Ken at home. She introduced a program that aimed to make him more mobile. Ken’s son John did the exercise program with him.
Ken joined a day rehab program, which added different exercises. John added those to the daily at-home routine.
Within six months, Ken could walk more than two kilometres unassisted and got around the house more easily, though still using a stick or a walker.
The exercise has dropped off a little, although he is still walking a kilometre a day. He is also doing a regular program of exercise and hydrotherapy twice weekly. Ken is happier than before, enjoying getting out of the house and moving more freely. Some of his boredom has eased. John believes the initial visits from the physio made an enormous difference.
Comment from physiotherapist Carmel
Ken is a motivated gent who is keen to improve. My job was made easy by having an interested and involved carer who supervised the home program and ensured that it was undertaken regularly and correctly. He was then able to attend the day rehab unit to further his program with increased intensity and challenge of exercises. Now Ken is attending our Strong and Steady program to continue to improve hismobility and function.
- Though such problems are probably not a consequence of dementia, they may be associated with pre-existing or comorbid health issues.
The National Dementia Helpline is an Australian Government funded initiative.