®Seated marching
Sit upright on a sturdy chair. Lift and lower your knees in turn, as if walking; swing your arms as well if you like. Doing it to favourite music makes it easier.
1–2 minutes; rest in between57 millionPeople living with dementia worldwide in 2021 (WHO)
60–70%Share of dementia cases due to Alzheimer’s disease
17 trialsCochrane review of exercise in dementia; 1,067 participants
150 minutesWeekly activity target for those who are able
What is dementia?
Dementia is not a single disease; it is a condition caused by various diseases that affect the brain. The most common cause is Alzheimer’s disease. Age is the strongest risk factor, but dementia is not a normal part of ageing.
At present there is no treatment that cures dementia. According to the World Health Organization, non-drug approaches can improve quality of life: rehabilitation, physical activity, social engagement, cognitive stimulation and support for carers.
Early signs
- Forgetting recent events, losing things
- Getting lost even in familiar places
- Losing track of time
- Trouble making decisions and solving problems
- Difficulty following conversations or finding words
- Difficulty with familiar tasks
- Changes in mood and behaviour; withdrawal
What can exercise do, and what can it not?
The Cochrane review looks at 17 trials and 1,067 participants. The results are modest:
- Daily activitiesThe ability to carry out daily activities such as dressing, washing and eating may be better in people who exercise. The quality of the evidence is very low, so no firm conclusion can be drawn.
- Memory and thinkingNo clear benefit was shown.
- Behaviour and depressionNo clear benefit was shown for behavioural symptoms or depression.
- CarersIn a single trial, having the carer supervise exercise at home reduced the burden on the carer.
- SafetyThe trials found no evidence that exercise is harmful.
Alzheimer’s Society makes the same point: exercise has not been shown to slow progression once dementia has started. Its benefits lie elsewhere: heart and blood vessel health, strength for daily tasks, balance, better sleep, time spent with others and a better mood.
Which activities are suitable?
The right activity depends on the stage of the disease and the person’s physical condition. The best starting point is to keep up the activities the person already enjoys for as long as possible, adapting them where needed.
- Daily activitiesHousework, shopping, and slowly standing up and sitting down all count as movement.
- WalkingThe most accessible activity; walking together is also a chance to talk.
- GardeningA moderate activity that also gets you outdoors.
- Dance and musicMoving to favourite music; this can also be done sitting down.
- Seated exerciseSuitable for people who find standing difficult. It can be made harder with a resistance band or light weights.
- Tai chi, yoga, swimmingOptions for balance and flexibility; dementia-friendly groups may be preferable.
Set the intensity with the talk test: during moderate activity you breathe faster and feel warmer; you can talk but not sing. Warm up before you start. If there is pain, dizziness, shortness of breath or feeling unwell, stop and ask your doctor.
Tips for carers
- Do it togetherWith someone alongside, activity is both safer and more enjoyable.
- Make it routineFor example a short walk at the same time each day, or standing up during the adverts on television.
- Show the stepsWrite the movements down and put them somewhere visible; mark the days they were done on a calendar.
- Do not set targetsAim for regular and enjoyable rather than counts and times.
- SafetyIf the person walks alone: familiar routes, a phone with them and a relative’s number on them.
- Look after yourself tooAsk for help, take regular breaks and do not neglect your own health. According to the World Health Organization, carers spend an average of five hours a day providing care.
Ask your doctor or physiotherapist before starting, especially if there is heart disease, high blood pressure, dizziness or fainting, bone and joint problems, breathlessness, balance problems or frequent falls. Seated exercises can put strain on the lower back; it is recommended to ask a doctor first about these too.
Exercises at home
Six movements to do together
The first four are done sitting down and are chosen from the seated exercises suggested by Alzheimer’s Society. Use a sturdy chair without wheels. Show the movement first, then do it together; do not rush.
Heel and toe raises
Sit with your feet flat on the floor. First lift your toes, keeping your heels down; then lower your toes and lift your heels.
10 repsRaising the arms
Sit upright. Slowly raise your arms towards the ceiling, then lower them. If your shoulder hurts, raise them only as far as is comfortable.
8–10 repsStraightening each leg in turn
Sit upright on a chair. Slowly straighten one knee, hold briefly and lower. Then do the same with the other leg.
8–10 repetitions with each legSit-to-stand from a chair
Sit towards the front of the chair, lean slightly forwards and stand up slowly; then sit down slowly. Use your hands for support if needed. Have someone alongside.
5 repetitionsWalking together
Walk at a comfortable pace on a route you know. You should be able to talk while walking. Walking together is safer and also a chance to talk.
Every day, even if only brieflyVideo
Dementia-friendly exercise videos
From the YouTube channel of NHS Greater Glasgow and Clyde, a health board in Scotland.
For strength and balance
Strength and balance exercises designed to be dementia friendly.
For strength and flexibility
Strength and flexibility exercises designed to be dementia friendly.
Frequently asked questions
Does exercise stop or slow dementia?
On current evidence, no: exercise has not been shown to slow or stop the progression of dementia. The Cochrane review found no clear benefit for memory and thinking. Even so, exercise may help preserve the ability to carry out daily activities, and it supports strength, balance, sleep and mood.
How much exercise is needed?
For those who are able, the target is a total of 150 minutes of moderate activity a week, plus strength, balance and flexibility work on at least two days a week. This is not a requirement but a good goal if it can be reached. Any movement helps, however little; short, frequent sessions are easier to manage than one long one.
My relative does not want to exercise; what can I do?
Rather than calling it “exercise”, do something they enjoy together: a walk, gardening, dancing to music. Go back to pastimes they used to enjoy. Do not set targets or counts; regular and enjoyable is enough. Small movements, such as standing up during the adverts on television, count too.
Can they go for a walk alone?
It depends on the stage of the disease. If they go out alone, it is advisable to keep to familiar routes, carry a phone or a location tracker and tell someone where they are going. They should carry an identity card with a relative’s phone number on it. If they have started to lose their way, walking together is safer.
When should you see a doctor?
Get help without waiting in the following situations:
- Confusion, drowsiness or agitation that worsens suddenly over hours or days
- Sudden weakness of the face, arm or leg; slurred speech (call 112)
- A blow to the head, severe pain or being unable to bear weight after a fall
- Chest pain, dizziness or shortness of breath during exercise
- Marked worsening of walking and balance over a short time, frequent falls
Sources
- Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S. Exercise programs for people with dementia. Cochrane Database Syst Rev. 2015;(4):CD006489.
- World Health Organization. Dementia. Fact sheet. 3 July 2026.
- Alzheimer's Society. Physical activity, movement and exercise for people with dementia.
- Alzheimer's Society. Exercise types and ideas for people with dementia.
- Alzheimer's Society. Getting started with exercise as a person with dementia.