Introduction

Dementia is a group of symptoms associated with a gradual decline in memory, thinking, problem-solving, daily activities, and behaviour. Engaging the mind in physical and mental activities can improve general mood, reduce the chances of developing mental health conditions, and slow disease progression. This article explores several activities that can positively impact people living with dementia, as well as their carers and loved ones.^1,2,3

What is dementia?

We can often feel mentally sluggish, forgetful and tired after a particularly stressful day, or as a result of illness, lack of sleep or even certain medications. However, if you are in your 60s or younger with memory loss and finding it difficult to complete tasks that were once fairly simple for you, it could be indicative of an underlying health issue. 

Dementia is a group of symptoms that affect memory, cognitive function (such as maths, logical reasoning, and language), mood, behaviour, and a person’s ability to carry out familiar daily tasks. These symptoms are progressive, meaning that they become worse over time. Sometimes, symptoms can develop at a relatively early age (i.e. before the age of 65), particularly if a close relative has been diagnosed with a form of dementia.^1,4 

Risk factors 

Some factors increase your chances of developing the syndrome. These include:⁵

• Older age
• Genetic susceptibility
• Some heart conditions, such as high blood pressure (hypertension), coronary artery disease and atrial fibrillation
• Previous history of stroke 
• A diagnosis of Parkinson’s disease 
• A diagnosis of type 2 diabetes

Lifestyle-related risk factors include:⁵

• Smoking
• A sedentary lifestyle
• Obesity

There are various types of dementia, characterised by the cause of the disorder and the abilities affected. The four most common types are:¹

• Alzheimer’s disease – this is the most common type of dementia
• Vascular dementia
• Lewy body dementia
• Fronto-temporal dementia 

Dementia is suspected when either the patient themselves or those close to them notice the following changes in their life that were not present before:⁶

• Cognitive changes: memory changes, issues with problem-solving, reading and writing, speaking, planning simple things and mixing up the order of things
• Behavioural changes: saying things inappropriate to the situation or surroundings, seeing or hearing things others can not, irritability or agitation, low mood, social isolation, wandering, repeating the same activity and sleep disturbances
• Difficulties with living independently: maintaining personal hygiene, dressing and carrying out familiar everyday activities 

Regular follow-ups with doctors and medication reviews are necessary to manage symptoms of dementia and potentially slow the progression of the disease. However, supplementing medical therapy with other holistic therapies can help improve overall quality of life.^6,7 

Importance of mental stimulation 

Cognitive benefits

Our brain forms new neural connections when we learn something, encounter new experiences or interact with people and things around us. This ability of the brain to adapt and reorganise itself in response to new experiences is called neuroplasticity. Good neuroplasticity is an indicator of brain health. Dementia affects this important ability of the brain, impacting the quality of a person’s life.⁸

Activities such as puzzles, memory games, and brainteasers can stimulate the brain. Dubbed ‘mental exercises’, these activities can slow the progression of cognitive difficulties in people living with dementia and improve attention and memory.

Emotional and social benefits

Dementia and its associated cognitive issues can reduce a person’s confidence. This can cause them to experience low mood and social isolation. It is important that people with dementia feel involved in activities and socialise with their loved ones. Engaging in group activities and accessible events can help reduce feelings of loneliness and depression. Emotional health is vital for brain health. Creating a support network and interacting with peers can empower people with dementia and stimulate their brains.⁹ 

Types of activities 

Cognitive exercises

Cognitive exercises help reduce the degeneration of the brain tissues, slowing down the decline in cognitive function. Some activities that individuals can engage in include engaging with patterns, jigsaw puzzles, memory games, riddles, word searches and familiar board games. These help improve concentration, analytical skills, special awareness, recall and logical thinking.⁸ 

Some examples include:

• Puzzles and games: jigsaw puzzles, Sudoku, Scrabble, familiar board games
• Memory exercises: matching images and words, repeating a string of words, word association games
• Storytelling and reading: Reading books, magazines or newspapers can help keep up with the world and preserve language skills. Storytelling sessions can be useful to foster listening and verbal communication skills as well as evoke memories of familiar experiences from the past

Physical activities

Gentle physical exercise can be incorporated into an individual’s routine to improve general and mental health. Exercise helps improve blood circulation to the brain and improve brain health. It also helps with awareness of surroundings and navigating through them, fostering a sense of independence. Exposure to natural environments with sunlight and fresh air is an added benefit to ensure health and well-being.¹⁰ Dementia-friendly activities include:

• Light aerobic exercise
• Walking with peers, carers and loved ones
• Dementia-friendly dance classes, tai chi lessons, yoga, swimming or gyms
• Outdoor activities such as gardening or bird-watching

These activities promote independence while fostering new social connections and improving mood. 

Creative activities

Creative activities include arts and crafts, sensory play, decorating and gardening. These help boost confidence in one's ability and foster a sense of accomplishment, helping create new connections in the brain. They can also help with skills, such as planning tasks, movement, spatial awareness and decision-making.¹¹ Some examples include:

• Arts and crafts: painting, drawing, knitting, decorating or any other craft project personalised to individual interests
• Music therapy: Listening to or singing favourite songs and playing musical instruments can be joyful. Music therapy is known to elevate the mood, reduce irritation and improve communication in people living with dementia

Social activities

Social activities that are specifically organised for people living with dementia and their loved ones are held throughout the UK by organisations such as the Alzheimer’s Society and Dementia UK. Some social activities include:

• Local memory cafes (dementia cafes) where you can meet other people with dementia and their loved ones or carers, share your experiences and reminisce about the past
• Dementia walks in woodlands and sensory parks: this can help involve different sensory stimuli and engage with different natural settings
• Singing groups: a wholesome activity to elevate the mood and socialise with others
• Book clubs and art classes to be more involved with communities
• Reminiscence work, where you share your experiences and memories with others. Re-exploring the past through photos, videos, objects, familiar music, and TV shows can help preserve core memories and feel emotions associated with the past

Social activities are crucial to managing the feelings of exclusion and isolation that stem from memory loss and disorientation associated with dementia. Being a part of a social group in a non-judgemental, safe space fosters a sense of belonging and engages the mind.⁹

Technological aids 

Cognitive apps and games

Digital platforms and applications made specifically for people living with dementia include games, puzzles, memory exercises, problem-solving games and simulation games. Digital platforms help provide a wider range of activities and help target specific skills in a more personalised way.¹² 

Online social platforms

Online platforms such as Zoom, Skype, and social media applications can enable people with dementia to socialise in a more controlled environment. Virtual hangouts are crucial during periods of isolation due to illness or mobility issues.¹²

Individually tailored activities

Personalised care plans

It is important to tailor activities based on the person’s interests and abilities (based on the severity of the disease). This ensures that the person is engaged with the activity and genuinely interested. Creating a personalised care plan based on their history, interests, previous occupation, past experiences and ability. Involving the family and loved ones can help create better activity plans for the person.

Adaptations for different stages of dementia

Dementia causes symptoms to worsen as the disease progresses. Activities must be tailored for each stage of the disease. While initially, the person may be more active and willing to engage, in the later stages, mobility is reduced. In the later stages, effort is made to engage in sensory play, targeting touching textures, scents, visuals, sounds, tastes and simple cognitive activities.

Occupational therapists and health care providers can help formulate plans by assessing the person’s ability and specific activities tailored to the target therapeutic areas. 

FAQs 

What are the early signs of dementia?

Early signs of dementia can include memory loss, difficulty concentrating, finding it hard to carry out familiar daily tasks, struggling to follow a conversation or find the right word, and becoming confused about time and place. These symptoms are often mild and can gradually worsen over time.¹³ 

Can dementia be prevented?

While there is no sure way to prevent dementia, maintaining a healthy lifestyle can reduce your risk. This includes regular physical activity, a healthy diet, keeping your mind active, not smoking, and controlling blood pressure and diabetes.

How does dementia affect daily life?

Dementia can affect daily life by impairing memory, cognitive skills, and the ability to perform everyday activities. It can also lead to changes in mood and behaviour, making it difficult to manage personal care, finances, and social interactions. 

Is there any support available for caregivers of people with dementia?

Support for caregivers includes respite care, support groups, counselling, and educational resources. The Alzheimer's Society and NHS offer valuable information and support services to help caregivers manage the challenges of caring for someone with dementia.

How does physical activity benefit people with dementia?

Physical activity can help maintain physical health, improve mood, and potentially slow cognitive decline in people with dementia. Activities such as walking, swimming, and yoga can be particularly beneficial, as they promote heart health and overall well-being.⁸ 

Can social isolation impact dementia?

Social isolation can worsen the symptoms of dementia and lead to further cognitive decline. Staying socially active and engaged can help maintain cognitive function and improve the overall quality of life for people with dementia.¹⁴

Useful sources of support

• The Alzheimer’s Society
• Dementia UK
• Dementia cafes
• Support for carers of people living with dementia

Summary 

• Dementia is a group of progressive brain disorders that causes a decline in brain function affecting memory, thinking, behaviour and ability to perform daily activities. Participation in cognitive, physical, creative and social activities is required to help manage symptoms better and slow cognitive decline
• Studies have shown that keeping active and engaging in mentally stimulating activities can slow cognitive decline and help manage symptoms better
• Cognitive exercise helps preserve mental function, problem-solving and analytical skills. Some examples include jigsaw puzzles, memory games and brainteasers
• Physical activities like gentle exercise, walking, dancing, yoga or tai chi can help maintain overall health and well-being, creative activities help provide an outlet for self-expression as well as planning tasks, decision making and a sense of accomplishment and social activities help reduce feelings of isolation and promote mental and emotional well-being
• It is important to involve healthcare providers and occupational therapists while making care plans to ensure that the activities are tailored to the person’s abilities and stage of illness