As the Dementia UK report indicates, severity of dementia is also linked to increasing age. There are therefore serious implications for quality of life (QL) and care of those living with dementia in long term facilities.
Dementia is characterized by a range of cognitive impairments such as difficulty in speaking, communicating and understanding, memory loss, and disorientation in space and time. Some people may also present behavioral symptoms that make them more likely to enter residential care.
The problem with declining functions and living especially in residential care is, mostly due to lack of human and financial resources, that stimulation, such as cognitive stimulation, physical stimulation, social stimulation, levels decrease significantly. The decline that follows is usually steep and leads to rapid deterioration of the individual.
Care home residents, in addition to cognitive impairment already present, are likely to quickly develop co-morbidities that require multiple medications; significant limitations in carrying out day to day activities including self-care; high levels of depression; and nutritional issues.
It is always good to walk, or do other exercise, and have company at the same time. Carers and other family members will enjoy being outdoors and exercising as much as people living with dementia.
1. Exercise as prevention
Physical exercise is one way that helps us to prevent fast deterioration of cognitive and physical functions. Decline in all functions is a normal part of ageing but when pathological processes are already present (e.g. dementia) the decline in functions is accelerated and becomes steeper and faster.
Exercising regularly has enormous preventive potential. Blood circulates regularly, making sure all organs have the necessary supply of nutrients and oxygen to function well for longer. Interventions carried out with people living with dementia in and outside of nursing homes (including people with mild cognitive impairment) reported improvements in gait speed and muscle strengthening of the lower body (Frandin et al, 2009). Such improvements might directly enable the person with dementia to become mobile and carry out day-to-day activities including self-care independently or with little assistance.
2. Exercise is stimulation – outdoor & company is the best
When living with dementia, we need as much stimulation as possible. Outdoor exercise and company while for example walking is a fantastic all-round stimulation for our brains. Human company is great and hugely stimulating and outdoor walking or other exercise provides many topics for conversation, will stimulate many areas in the brain, what do we see, what do we feel, what do we smell, what is around us and how has it changed over the past years etc. Also, going outdoors regularly makes us get more vitamin D that is vital for our bones to stay healthy.
3. Regular exercise improves our mood & helps to tackle depression
Exercise sessions have been reported to improve mood in general amongst people living with dementia. Depression in people living with dementia is one of common problems with serious and costly consequences. Exercise is seen as one possible treatment and evidenced as having a clear benefit of depression in people living with dementia in nursing home residents and in community.
4. Regular exercise will help to eat better and drink more water
When we exercise regularly our bodily functions regularise as well. Our basic metabolic rate is higher, bowel functions regular, all organs including brain have a regular supply of nutrients and we are usually hungrier. This prompt us to eat a bit more and in regular intervals. The only other thing we need to keep in mind is regularly drink water, even when we are not thirsty. Daily intake of water should be more than 1.5 litres a day. 1.5 litres is a strict minimum to make sure there is enough water in our bodies for metabolic processes. If we do not drink enough water every day, our metabolism slows down, organs functions decline faster. Severe dehydration worsens symptoms of dementia, it can accelerate memory loss, dizziness and confusedness. Dehydration also prevents drugs, we might be taking on regular basis, to clear out of the system. This may lead to negative drug interactions. This can increase sedation, dizziness, confusedness and worsen depression. Good hydration is absolutely essential.
5. Regular exercise helps the body to get moderately tired and brain sleep better
Sleep disturbances are common amongst older people in general and specifically in older people living with dementia. Degenerative neurologic disorders that cause dementia, such as Alzheimer’s disease and Parkinson’s disease, exacerbate age-related changes in sleep, as do many common comorbid medical and psychiatric conditions. Getting a regular habit to exercise has been suggested as one possible ways to improve sleep in people living with dementia and their carers.
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