Dementia

Dementia

Dementia is an umbrella term used to describe a group of symptoms caused by diseases or conditions that damage the brain. It can affect memory, thinking, communication, behaviour, mood, movement and the ability to carry out everyday activities.

Everyone experiences dementia differently. The symptoms and the way they progress depend on the type of dementia, the areas of the brain affected and the individual. Dementia is not a natural part of ageing, and symptoms can change over time.

At Positive Steps Physiotherapy, we support people with dementia to maintain their movement, physical function, independence and participation in the activities that are important to them.

What are the different types of dementia?

There are many different types and causes of dementia. Some of the most common include:

Alzheimer's disease

Alzheimer's disease is the most common cause of dementia. It is associated with changes in the brain, including abnormal deposits of proteins such as amyloid and tau, which can damage and eventually destroy brain cells.

Alzheimer's disease commonly affects memory, thinking, language and the ability to plan and carry out everyday activities.

Vascular dementia

Vascular dementia is caused by problems with the blood supply to the brain, which can damage brain tissue.

It can affect thinking, attention, planning and problem-solving. It may also affect movement and physical function, including walking and balance. Symptoms can sometimes develop suddenly, particularly following a stroke, or progress more gradually.

Dementia with Lewy bodies

Dementia with Lewy bodies can affect attention and alertness, movement and thinking. People may experience fluctuations in their level of alertness, visual hallucinations, sleep disturbances, falls and changes in movement.

Frontotemporal dementia

Frontotemporal dementia (FTD) affects areas of the brain involved in behaviour, personality, language and communication.

The symptoms can be different from those commonly associated with Alzheimer's disease, particularly in the early stages.

Mixed dementia

Mixed dementia occurs when a person has more than one type or cause of dementia. A common combination is Alzheimer's disease and vascular dementia.

The symptoms of mixed dementia depend on the underlying conditions and the areas of the brain affected.

What causes dementia?

Dementia is caused by diseases or conditions that damage brain cells. Different types of dementia affect the brain in different ways.

There are also factors that can increase a person's risk of developing dementia. These can include:

• Increasing age

• High blood pressure

• High cholesterol

• Diabetes

• Cardiovascular disease

• Physical inactivity

• Smoking

• Family history and genetic factors

Having one or more of these risk factors does not mean that someone will develop dementia.

How common is dementia?

Dementia is a major health condition affecting people across the UK. The NHS currently reports that more than 944,000 people in the UK have dementia, with around 1 in 11 people over the age of 65 affected. The prevalence increases with age.

Dementia statistics change over time, so figures should be reviewed regularly when this page is updated.

What are the symptoms of dementia?

Dementia affects everyone differently, and symptoms depend on the type and stage of the condition.

Symptoms can include:

• Memory difficulties

• Difficulty concentrating or paying attention

• Problems with planning and organising

• Difficulty solving problems

• Changes in language and communication

• Difficulty carrying out familiar everyday activities

• Confusion about time or place

• Changes in mood or behaviour

• Reduced confidence

• Changes in movement and coordination

• Balance difficulties

• Changes in walking or gait

• Reduced strength and physical activity

• Increased fatigue

• Difficulty maintaining independence

Some types of dementia can also cause specific symptoms. For example, vascular dementia can be associated with walking and movement difficulties, while dementia with Lewy bodies can involve changes in alertness, movement, falls and visual hallucinations.

As dementia progresses, some people may experience increasing difficulties with communication, mobility and everyday activities and may require more support.

How is dementia diagnosed?

There is no single test that can diagnose dementia.

A healthcare professional will usually consider a person's symptoms, medical history and how changes are affecting their everyday life. This may include cognitive assessments, physical examinations and blood tests to help rule out other possible causes of symptoms.

A brain scan, such as an MRI or CT scan, may also be used as part of the assessment to help identify the underlying cause and rule out other conditions.

If you or someone you know is experiencing changes in memory, thinking, communication or everyday function, it is important to speak to a GP or appropriate healthcare professional.

Can physiotherapy help people with dementia?

Yes. Although physiotherapy does not treat the underlying disease causing dementia, it can play an important role in maintaining physical function, mobility and independence.

Physical activity and exercise can support strength, balance, mobility, cardiovascular fitness and confidence. For some people, exercise can also support sleep, mood, energy levels and social participation. Exercise should always be appropriate for the person's abilities, needs and stage of dementia.

Physiotherapy can focus on helping a person continue to do the things that are meaningful to them, whether that is walking independently, getting up from a chair, moving around their home, taking part in hobbies or remaining active in their community.

How can physiotherapy help with dementia?

At Positive Steps, physiotherapy may focus on a range of physical and functional goals.

Movement and exercise

Individualised movement and exercise programmes can help maintain physical activity, strength, mobility and function.

Exercises can be adapted depending on the person's abilities, interests, environment and goals. This may include standing exercises, seated exercises, functional movements or activities that encourage whole-body movement.

Strength and fitness

Maintaining muscle strength and cardiovascular fitness can help support everyday activities such as standing, walking, transferring and getting up and down from a chair.

Exercise can be progressed or adapted as a person's abilities and needs change.

Balance and falls prevention

Balance difficulties and changes in mobility can increase the risk of falls.

Physiotherapy can assess balance and identify areas that may be contributing to falls. Treatment may include practising balance in different positions and during functional activities, strengthening exercises and strategies to improve confidence and safety when moving.

Walking and gait rehabilitation

Changes in walking can occur in different types and stages of dementia.

Physiotherapy can assess walking, mobility and confidence and work on strategies to support safer and more efficient movement.

This may include practising different walking tasks, changing direction, navigating obstacles or working on mobility within everyday environments.

Transfers and functional mobility

Physiotherapy can assess how someone moves between different positions, such as:

• Sitting to standing

• Standing to sitting

• Getting in and out of bed

• Moving between a chair and another surface

• Getting down to and up from the floor

Where appropriate, practising these movements can help maintain independence and improve confidence with everyday mobility.

Falls education and floor transfers

If appropriate, physiotherapy can teach a person how to safely get down to the floor and return to standing.

This can form part of a wider falls prevention programme and can help someone understand strategies they can use if they do experience a fall.

Fatigue and activity management

Some people living with dementia may experience fatigue or reduced energy.

Physiotherapy can help individuals and their families understand how to balance activity and rest. Strategies may include pacing, planning activities and identifying the best times of day for physical activity.

Pain, stiffness and positioning

Pain and stiffness can affect movement and participation in everyday activities.

Physiotherapy may use appropriate movement, exercise, positioning and advice to help manage physical discomfort and maintain mobility.

Where appropriate, we may also consider supportive equipment or positioning strategies to improve comfort.

Maintaining independence

One of the key aims of physiotherapy is to help people maintain their independence for as long as possible.

This may involve practising meaningful everyday activities, adapting exercises, improving confidence with mobility or identifying ways to make activities safer and more achievable.

Education and support for families and carers

Physiotherapy can also involve working with families, carers and support teams.

We can provide advice about movement, exercise, mobility, falls prevention and ways to encourage physical activity safely within everyday routines.

Where appropriate, we can also signpost families to other organisations and services that can provide additional dementia-related support.

What might dementia physiotherapy involve?

Every person's physiotherapy programme will be different.

An initial assessment may consider:

• Current mobility and walking

• Balance and falls history

• Strength and physical function

• Transfers

• Exercise capacity

• Pain or stiffness

• Fatigue

• Confidence with movement

• Everyday activities

• The person's home or usual environment

• Personal goals and interests

• Support available from family, carers or other professionals

Treatment is then tailored around the person's needs and goals.

For someone with dementia, the way an activity is presented can be just as important as the activity itself. Sessions may use repetition, familiar activities, visual or verbal prompts and meaningful tasks to help someone engage with movement and exercise.

Specialist rehabilitation equipment at Positive Steps

Positive Steps has access to a range of specialist rehabilitation equipment that may be incorporated into an individual's physiotherapy programme when appropriate.

EzyGain treadmill

The EzyGain can provide supported walking practice and can be used to assess and work on aspects of gait, mobility, balance and confidence.

The level of support can be adapted according to the individual's needs and abilities.

BlazePods

BlazePods are interactive lights that can be incorporated into movement and rehabilitation activities.

They can be used in different positions and environments to work on movement, balance, coordination, reaction and engagement in an interactive way.

Hydrotherapy

Hydrotherapy uses the properties of water to support movement and exercise.

The water can provide support and resistance, allowing certain movements and exercises to be practised in a different environment. Warm water may also be helpful for some people experiencing stiffness or discomfort.

Hydrotherapy is only appropriate for some individuals and would be considered following an assessment of their needs.

MOTOmed

The MOTOmed provides repetitive assisted or active movement of the arms and/or legs.

It may be used to encourage repetitive movement and support mobility, coordination and physical activity, depending on the individual's abilities and rehabilitation goals.

All equipment and rehabilitation approaches are selected based on individual assessment rather than being automatically appropriate for everyone with dementia.

How can Positive Steps help?

At Positive Steps Physiotherapy, we understand that dementia can affect every person differently.

Our approach is centred around the individual, their abilities, their goals and the things that are important to them. We work with each person to identify what can be done, rather than focusing solely on what has become difficult.

Physiotherapy can help people living with dementia to maintain movement, strength, balance, mobility and physical independence. We can also work alongside families, carers and other professionals to support safe and meaningful participation in everyday activities.

As dementia is progressive and a person's needs can change over time, physiotherapy can be adapted as their abilities, goals and circumstances change.

Our aim is to help people continue to move, participate and do the things they enjoy for as long as possible.

If you would like to find out how physiotherapy at Positive Steps could support you or someone you know living with dementia, please get in touch with our team.

Dementia support organisations

There are several organisations providing information, advice and support for people living with dementia and their families and carers.

Alzheimer's Society
Information, advice and support for people affected by dementia.

Dementia UK
Specialist dementia support, including advice for families and carers.

Alzheimer's Research UK
Information about dementia research and the causes of dementia.

Age UK
Information and support for older people, including dementia-related support available locally.

For medical concerns or concerns about new symptoms, please speak to your GP or appropriate healthcare professional.