Exercise and dementia: What does the latest research tell us?

The Bottom Line

  • Regular exercise is important for health and helps reduce the risk of many diseases.
  • There is evidence that exercise may help people with dementia better perform activities of daily living, helping to maintain their independence as long as possible.
  • Certain types of exercise may be beneficial for some; high-quality research is needed to determine if this is true.

Problems with brain function and memory that interfere with one’s daily function (also called cognitive impairment) are one of the most pressing health care issues. So far, no effective medication has been found to prevent the progress of cognitive impairment and onset of dementia (1). That’s why there’s so much interest in lifestyle approaches for prevention or treatment. Many people want to know, “What can I do to keep my brain healthy and functioning well?”


Regular physical exercise is a great way to promote good health throughout life. Recent long-term studies of aging show that people who are more active have less risk of chronic disease, disability or depression, and are more likely to keep up their activities of daily living (ADL) (2;3). Not to mention the benefits of exercise for preventing falls (4;5), fitness and quality of life for older adults (6;7). Exercise helps us feel better, and enjoy a healthier, more active lifestyle for a longer period of time. Exercise also has few side effects and can be inexpensive and enjoyable!


But does it help prevent – or at least slow – cognitive impairment and improve life for people with dementia? 


What the research tells us

A systematic review which included 17 randomized controlled trials measured the impacts of various types of exercise on 1,067 older adults already diagnosed with dementia (8). The review found promising evidence that exercise may help people with dementia improve their activities of daily living – for example bathing, dressing, eating – which can help people facing cognitive decline to maintain their independence (8;9;10). This is a particularly interesting and important finding since people with cognitive impairment often find it more difficult to perform activities of daily living.


It is also possible that certain types of exercise – and how often or intensely we do them – may benefit brain health and function more than others. Tai Chi, for example, may be a promising way to help protect, and even enhance, cognitive function among healthy adults as reported in another recent systematic review. The authors of this review go on to say it may also be possible that some people may benefit more from exercise, depending on their age, level of fitness, cognitive health, and severity or type of dementia diagnosis (11). More high quality studies are needed to learn more about the long-term benefits of exercise for brain health and cognitive function, but the most recent evidence is promising (9)!


No matter what the research says about the impact on cognition, there are already enough compelling reasons to exercise that the decision to embrace physical activity is a “no-brainer!”


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References

  1. Cooper C, Li R, Lyketsos C, Livingston G. . Br J Psychiatry. 2013; 203(3):255-64.
  2. Almeida OP, Khan KM, Hankey GJ et al. 150 minutes of vigorous physical activity per week predicts survival and successful ageing: a population-based 11-year longitudinal study of 12,201 older Australian men. Br J Sports Med. 2014; 48:220-5.
  3. Hamer M, Lavoie KL, Bacon SL. Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing. Br J Sports Med. 2014; 48:239-243.
  4. Chan W.C., Fai Yeung J.W., Man Wong C.S., et al. Efficacy of physical exercise in preventing falls in older adults with cognitive impairment: A systematic review and meta-analysis. J Am Med Dir Assoc, 2015; 16:149-154.
  5. El-Khoury F, Cassou B, Charles MA, & Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: Systematic review and meta-analysis of randomised controlled trials. BMJ. 2013; 347: f6234.
  6. Weening-Dijksterhuis E, de Greef MH, Scherder EJ, et al. Frail institutionalized older persons: A comprehensive review on physical exercise, physical fitness, activities of daily living, and quality-of-life. Am J Phys Med Rehabil. 2011; 90:156-168.
  7. Bullo V, Bergamin M, Gobbo S, et al. The effects of pilates exercise training on physical fitness and wellbeing in the elderly: A systematic review for future exercise prescription. Prev Med. 2015; 75, 1-11.
  8. Forbes D, Forbes SC, Blake CM et al. Exercise programs for people with dementia. Cochrane Database Syst Rev. 2015; 4:CD006489.
  9. Martin-Ginis KA, Heisz J, Spence JC, et al. Formulation of evidence-based messages to promote the use of physical activity to prevent and manage Alzheimer’s disease. BMC Public Health. 2017; 17(1):209. doi: 10.1186/s12889-017-4090-5. 
  10. Lewis M, Peiris CL, Shields N. Long-term home and community-based exercise programs improve function in community-dwelling older people with cognitive impairment: A systematic review. J Physiother. 2017; 63(1):23-29. doi: 10.1016/j.jphys.2016.11.005. 
  11. Wayne PM, Walsh JN, Taylor-Piliae RE, et al. Effect of Tai Chi on cognitive performance in older adults: Systematic review and meta-analysis. J Am Geriatr Soc. 2014; 62:25-39.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.