4.1 Boost your physical health

Your physical health affects your brain

Keeping your body healthy will help to keep your brain healthy, helping you to stay active and have better quality of life.

Research shows that people with dementia who do regular physical activity are more likely to keep their brain going, to keep doing everyday things and stay independent. 

Blood and oxygen flow to the brain, affecting how well the brain works. If your heart is working better, your brain will get more blood and oxygen. Physical activity increases blood and oxygen flow to the brain and keeps your heart healthy. It also helps you stay strong and mobile so you can go about your daily life.  Balance exercises can also help you to stay safe and avoid falls.

Food is fuel for your brain. Your brain needs enough of the right types of fuel to work best. Your diet affects the chemicals that your body makes including chemicals in the brain (called neurotransmitters).  A good diet also helps to protect your heart, give you energy and maintain a healthy weight.

Sleep is also important for your brain. Scientists think that while you sleep important processes happen in the brain, such as removing toxins. Evidence shows that getting at least seven hours of sleep reduces the risk of getting dementia.  You may feel that you are able to think more clearly after a good night’s sleep.  Excessive sleep, say more than 10 hours per day, may be a sign of a medical condition. 

People who have fewer health conditions, and less risk factors for heart disease (such as they don’t smoke, are not overweight, do not have high cholesterol or diabetes) are less likely to get dementia.   It is possible that managing your health and heart disease risk factors may slow down how quickly dementia progresses. 

Physical activities and exercise

Keep healthy by being physically active 

When people think about exercise, they often think of aerobic exercise. These are exercises which raise your heart rate and make you out of breath. Jogging, swimming, cycling, brisk walking are all examples of aerobic or cardio exercises. 

Aerobic exercise has been shown to help people with dementia with their memory and thinking, and in some studies their daily tasks.  This kind of exercise can also help with your mood, how well you sleep and your physical health. There is evidence that strength training, may also be good or even better for the brain, see below. You can cross-train, that is use both types of exercise.

For adults and older adults, the UK government recommend:

• At least 150 minutes a week of exercise which makes you breathe more but you can still talk such as brisk walking, cycling or swimming

Or

• At least 75 minutes a week of activities which make you breathe fast and it is difficult to talk

You can do a combination of these and they also recommend you break up periods of time when you are inactive or resting.

Here is a guide to help you choose exercises for you.

You can download the free ‘Active 10’ app to help you keep track of your activity 

Strength training

Strength training or resistance training is exercise which helps to keep your muscles, bones and joints strong.  This will help to keep you from becoming frail.  Strength based exercises include using your own bodyweight as resistance (such as press ups, squats and lunges), lifting weights or using exercise bands.  Yoga, going to the gym or carrying heavy bags count too. Some studies suggest that combining aerobic activity and strength training is best. 

For adults and older adults, the UK government recommend doing strength training on at least two days a week.

If you haven’t done strength training before, you might want to join a class. 

Start slow and build up gradually. 

If you don’t do much exercise, start slowly. Try doing a 15 minute walk a few times each week. Then build up to walking for longer and more often.  If you are worried about going out walking, try to arrange to go with someone or use technologies to help you Dealing with memory and thinking  and Managing difficulties when out.

Try to do activities you enjoy, as you’re much more likely to stick with it. Many people prefer to exercise with others. You might enjoy dancing, the gym, golf or meet a friend regularly for a walk. Build exercise into your weekly routine so it becomes a habit.

Organisations such as Age UK run a range of exercise classes such as yoga, pilates, and walking groups.  They also run activities such as walking football . These are a great option for getting advice on your exercise and meeting new people.  They also offer online exercise options for people who aren’t able to get to classes. 

Many gyms also offer ‘off peak’ discount or special rates for older people.  Many local councils run gyms and there are also many private gyms available too.

If you have health conditions, talk to your doctor before starting to exercise for advice about what’s safe for you to do. If you feel faint, dizzy or pain, stop and talk to your doctor.

Everyday activities and exercise

Some people prefer to build exercise into their everyday life. You might walk up the stairs rather than take a lift, walk to the shops rather than drive, and do the vacuuming or gardening.  The NHS physical activity guidelines for older people suggests which household tasks count as light exercise.

Exercises to help you keep safe and avoid falls

Balance is an important part of exercise.  As we get older our ability to balance or recover when we are thrown ‘off balance’ reduces with age. Poorer balance has a greater risk of falling and injury.  Research shows that with regular practice, everyone can improve their balance. 

Balance exercises help you to safely challenge your ability to balance. The NHS website provides a step by step guide to practicing simple balance exercises.

People with dementia fall more often than people of the same age without dementia, exercise can help you to avoid falls. Falls prevention programmes usually combine strength, balance, and flexibility exercise. Falls prevention programmes will also often suggest changes you can make around your home to reduce your risk of falls.   You can find out about simple changes you can make in your home to avoid falls Managing difficulties at home. 

Age UK also offers a range of falls prevention resources. 

If you or the person you support fall regularly speak to your or their GP.  They may refer you to a falls or syncope clinic for assessment. 

Eat and drink well

Some people with dementia find their appetite changes. You might feel more or less hungry or crave unhealthy food.  For example, people with frontotemporal dementia sometimes develop a sweet tooth. Because of appetite changes people with dementia sometimes gain or lose weight. Some people forget to eat and can become malnourished. Try to maintain a healthy weight. If you are low on certain vitamins and minerals this can affect how well your brain works. Your diet is important for brain health. 

If you have concerns about your weight, diet or appetite, talk to your doctor. They might send you to a dietitian for further advice.  If you have difficulties swallowing certain foods, ask your doctor to refer you to a speech and language therapist who can give you advice and support.  The Alzheimer’s Society has a helpful article on how speech therapists can help.  

Eat a healthy diet

Research shows a Mediterranean diet can help prevent dementia, but there is no proof this diet helps people who already have dementia. A Mediterranean diet includes lots of vegetables and fruits, pulses and nuts, wholegrains, fish and seafood and olive oil, as well as some dairy 

Government guidelines can help you to make healthy choices.  General advice suggests:

• Use salt sparingly 
• Eat and drink less sugar 
• Eat foods low in saturated fats and high in calcium and fibre. 

It is also important to eat foods you enjoy and which take into account your cultural and religious preferences.  Make sure others are aware of your likes and dislikes

Smoking and alcohol

Helpful government guidance is available on alcohol awareness and stopping smoking.  Drinking alcohol may help you relax, however it can also make some dementia symptoms such as confusion worse.  Read more about smoking and alcohol. 

Drink 8-10 cups of water a day

Our brains work better when we are well hydrated.  Not drinking enough water can cause problems such as becoming more confused, headaches, urine infections and constipation. Drinking at least 8 cups of water a day will help you to stay well hydrated. It’s easy to forget to drink, and as we get older we are less able to recognise when we are thirsty.  Make it part of your routine to have a glass of water with every meal, and in between meals too. Water is the healthiest choice, but tea, milk, juice, and soup also help.  Read more about drinking, hydration and dementia. 

You can watch a video with top 5 tips to help older people drink well and stay hydrated https://vimeo.com/582023804.

Improve your diet gradually

It’s hard to change habits, including your diet. Food is more than nutrition. Food can be enjoyment, comfort, a way to express yourself or your culture. Changing your shopping habits can help change your diet – for instance, buy more healthy food, and less junk food.

Start with one or two small food changes until they become habit. Such as drinking enough water or eating more fruit.

Rest well

Take breaks during the day

You may find everyday activities such as having lunch with friends, having visitors or going to the cinema more tiring. Having breaks between activities can help you recharge. You might also find it helps to plan only one or two activities a day or having rest days. 

Get at least 8 hours of sleep a night

People often notice changes to their sleep patterns as they get older. You may need less sleep than you used to or take longer to fall asleep. Dementia may also affect your sleep.  You might feel very sleepy through the day and may not being able to get to sleep or stay asleep at night.  Read more about how dementia can affect your sleep. 

Suggestions to help you sleep better:

• Have a routine – go to bed and wake up at the same time each day.
• Sleep is important – make it a priority
• Take short naps in the early afternoon
• Make sure you have enough exercise and activity during the day
• Have a familiar night time routine such as getting changed into nightclothes, brushing your teeth before bed
• Have a comfortable mattress, pillow and bedding and make sure you are not too hot or too cold
• Listen to relaxing music
• Avoid drinking straight before you go to bed, to reduce the need to go to the bathroom
• Find out if any medications you take might be affecting your sleep.

Sleeping problems and dementia

Whilst you may find sleeping more difficult, some people may experience certain sleep problems.  For example, people with Lewy body dementia, are more likely to experience restless legs syndrome. This makes you want to move your legs, especially at night, and may keep you awake.

It is also more common for people with dementia to have sleep apnoea. This means you stop breathing for short periods of time while you are asleep.  You may snore loudly or wake suddenly. Ask your partner if they’ve noticed you snore loudly and have periods where you stop breathing. Read more about night time disturbance here. 

If you are experiencing trouble with your sleep or have sleep apnoea, talk to your doctor. 

Manage other health issues

If your overall health is well managed, your brain health will benefit. People with dementia may have other long-term conditions such as heart disease, diabetes, arthritis, osteoporosis, asthma, or chronic obstructive pulmonary disease (COPD). Make sure you visit your general practitioner and specialists regularly for check-ups. Take your medications correctly and follow their lifestyle advice. A healthy lifestyle will help with all chronic diseases. 

People with dementia are more at risk of getting other health conditions such as delirium, incontinence (problems controlling urine or bowel movements), problems with your vision, dental problems, and becoming frail. Have regular check-ups at the optician and the dentist.   Talk to your doctor or specialist nurse to manage other conditions such as a diabetes nurse. Be on the lookout for changes in your health and how you feel and see your doctor when changes you notice changes. 

Read how to look after your foot, bone and dental health to stay well

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