Lifestyle Changes to Ease Dementia Symptoms

These approaches can support healthy brain aging and prolong everyday function

McKenzie Prillaman

Reviewed by

Jessica Z.K. Caldwell, Ph.D.

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En español

Published January 17, 2024

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You may have heard the hype around the drug Leqembi, approved in 2023 for people with early signs of Alzheimer’s disease, the most common cause of dementia. It was newsworthy because it was shown to, at least temporarily, put the brakes on the impending loss of memory and thinking skills. And it did so better than similar drugs.

But medications don’t have to be step one for people with dementia — in fact, they’re not always an option. Lifestyle changes, on the other hand, can be made by anyone. And some have been proven to support healthy brain aging, improve quality of life and prolong the ability of someone in early stages of dementia to accomplish everyday activities.

“You’re not necessarily slowing the neurodegenerative process itself,” says neuropsychiatrist Chiadi Onyike, M.D., director of the Frontotemporal Dementia and Young-Onset Dementias Clinic at Johns Hopkins Medicine. But you’re slowing the impact of that process on the ability to function, he says.

Health professionals generally recommend that people with dementia make a few simple tweaks to their daily routine and diet. These activities can be tailored to a person’s goals and interests and are typically advised as a first step. They can also be helpful for people taking medications. Extra bonus for making this effort a family affair: These changes may help anyone who is trying to live a healthier life and reduce their risk for dementia.

4 changes to make after a dementia diagnosis

Move more. Raising your heart rate with physical activity has plenty of brain benefits — and exercises don’t need to be super strenuous. “We’re not asking people to go into the gym and pump iron,” Onyike says. “We’re asking them to walk.” He encourages his patients to walk for 30 minutes every day. Other activities could include swimming, dancing or yoga.

Among people with Alzheimer’s disease, those who did more than 16 weeks of regular exercise — activities like tai chi and stationary cycling while watching their route on a screen — had better cognition and could complete more daily living activities than people who relied only on symptom-relieving medications, according to a meta-analysis of 12 randomized controlled trials reported in 2023 in Brain and Behavior.

“When you look at the data on exercise and the impact on brain function and brain health, it’s remarkable — it’s more potent than any medication we’ve ever had,” says geriatric psychiatrist Brent Forester, M.D., chairman for the Department of Psychiatry at Tufts Medical Center in Boston and coauthor of the 2022 book The Complete Family Guide to Dementia.

Upgrade your diet. Rather than being a restrictive eating plan, the Mediterranean diet emphasizes fruits, vegetables — especially leafy greens — whole grains, olive oil, nuts and legumes. Moderate amounts of fish, poultry, dairy and eggs are included as well. These go-to foods help reduce inflammation and oxidative stress, both of which drive loss of nerve cells.

A recent analysis from the Rush Memory and Aging Project suggests the Mediterranean diet may help protect the brain from damage associated with Alzheimer’s disease, researchers reported in 2023 in the journal Neurology. Following this eating plan also reduces risk for cardiovascular disease, type 2 diabetes and obesity — all risk factors for dementia.

People with Parkinson’s disease, a brain disease that can cause dementia, may benefit as well. In a study of 70 people with the disease, those who followed the Mediterranean diet for 10 weeks performed better on a cognitive test — especially on the ability to plan ahead, pay attention and concentrate — than those who did not, researchers reported in 2020 in Complementary Therapies in Medicine.

Engage your mind. Give your brain a little push by keeping it engaged. “You have to find something stimulating enough that’s interesting and enjoyable, but is also a challenge,” Forester says. Some people love doing crossword puzzles. Others don’t. Interests and abilities may change as the disease progresses, but there are plenty of options, including playing card or board games, reading magazines, painting, playing a musical instrument or listening to music. Revisiting old hobbies may spark an idea.

“When you look at the data on exercise and the impact on brain function and brain health, it’s remarkable — it’s more potent than any medication we’ve ever had."

Brent Forester, M.D., geriatric psychiatrist

Among 87 adults between ages 70 and 88 with either mild cognitive impairment or Alzheimer’s disease, those who regularly did cognitive activities — such as learning strategies to remember names or discussing music — or who exercised for six months had no decline in performance on a cognitive test, in a study reported in 2019 in Aging. Participants who did neither activity experienced cognitive decline. “Just like we exercise our bodies, it’s important that we exercise our brains,” Forester says.

Socialize more. Staying connected with other people can slow cognitive decline and support mental health. But maintaining a social circle can be especially challenging for people with dementia, Forester says. Some families become overprotective, keeping their loved one with dementia at home. Other times, the person with dementia may not want to leave their house or apartment. It’s vital to get that individual chatting with neighbors, friends and family or into an adult day program Forester says. “Spending time with the people that they care about really matters.”

Overall, Forester recommends a shift in perspective surrounding dementia. “Really focus on positive things that one can do despite having the illness as opposed to what one can no longer do.”

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6 Ways to Cope With Dementia Symptoms

Dementia is often accompanied by behavioral and psychological symptoms that may change as the disease progresses. “A symptom could be as mild as worrying; it could be as severe as physical aggression,” Forester says. Several approaches can help an individual cope and reduce frustrations and unnecessary difficulties.

Psychotherapy. Talking to a mental health professional can be valuable in the early stages of dementia. A person might struggle with their diagnosis, fearing or grieving for their future, Forester says.
Support groups. Support groups provide safe spaces to talk with people in the same situation, with no embarrassment or fear of being misunderstood, Onyike says.
Vision and hearing checkups. Vision and hearing problems can add to confusion, making it harder to recognize loved ones, for example. Get or update eyeglasses or hearing aids, as needed.
Mental health review. “People with a long history of mental illness are at a higher risk for dementia later in life,” Forester says. Those taking medications for a previously diagnosed mental health condition should check in on drug choices and doses, as drug metabolism changes with age and there are risks of drug interactions if new medications are added to the mix.
Organization. A tidy home with labeled storage spaces can help a person with dementia easily locate things they need, avoiding frustration. A calendar or other visible reminders in the home can remind them of upcoming plans.
Find the root of the issue. There may be times when a person with dementia might display more aggressive behaviors, including verbal or physical outbursts. It’s important to determine the cause. There might be physical discomfort, such as pain or sleep deprivation. An overstimulating environment could also be distressing.

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McKenzie Prillaman is a freelance science and health journalist based in Washington, D.C. Her work has appeared in Nature, Scientific American and Science News, among other publications.

Jessica Z.K. Caldwell, PhD, is a neuropsychologist and director of the Women's Alzheimer’s Movement Prevention Center at Cleveland Clinic. She has expertise in dementia, Alzheimer’s disease and dementia risk reduction.