Cognitive impairment can affect abilities such as memory, attention, language and orientation, with varying degrees of severity from one person to another.
Performing adapted exercises and activities can help keep preserved abilities active, encourage participation and add structure to the person’s routine. The aim should not be to test them or demand correct answers, but to provide a meaningful and enjoyable experience.
In this article, we present exercises for cognitive impairment and activities for older adults adapted to different levels of impairment and individual needs.
Exercises for people with cognitive impairment
Exercises for people with cognitive impairment are structured tasks that can be used to work on abilities such as memory, attention, language, orientation and planning.
Some examples include:
- Remembering visual information: looking at several images or objects and trying to recall them afterwards.
- Classifying items: grouping words, photographs or objects according to their category, purpose, colour or shape.
- Arranging sequences: placing the steps required to complete an everyday task in the correct order.
- Completing familiar information: finishing proverbs, songs or familiar expressions.
- Finding specific items: locating a letter, number or symbol on a page.
- Matching objects to their function: linking each object to the action for which it is used.
- Identifying different items: indicating which object or image does not belong to a group.
- Working on orientation: using a calendar to identify the day, month or a planned activity.
- Planning a task: choosing the materials and arranging the steps required to complete it.
- Following instructions: carrying out a short sequence of actions.
Exercises can be performed orally, in writing or by using images and everyday objects. The format should be chosen according to the person’s abilities and any visual, hearing or motor difficulties they may have.
It is not always necessary to use worksheets or specific materials. A recipe, a calendar, several items of clothing or a few everyday objects can be used to create understandable exercises connected to the person’s surroundings.
For more ideas, see our article on cognitive stimulation for adults and our guide to improving memory in older adults.
Activities for older adults with cognitive impairment
Activities for older adults with cognitive impairment do not need to be limited to worksheets or written exercises. Household tasks, music, movement, creative activities and social participation can help people remain connected to their surroundings in a more natural way.
Unlike a structured exercise, these activities do not have to end with a specific answer or result. Their value lies in the participation, usefulness and meaning they offer the person.
The level of impairment can provide guidance when selecting activities, but two people with a similar diagnosis may retain different abilities and require different types of support.
Activities for older adults with mild cognitive impairment
When cognitive impairment is mild, the person usually retains much of their independence. Activities can include small decisions, several steps or situations that require organisation, while encouraging the person to continue participating actively.
Some suggestions include:
- Preparing a familiar recipe: gathering the ingredients, following the steps and helping with the preparation. If necessary, some materials can be prepared in advance or a list can be used.
- Doing some simple shopping: creating a short list, finding the products and reviewing the purchases with support.
- Organising photographs: grouping them by people, places, celebrations or periods of life without requiring exact dates or names.
- Caring for plants: checking whether they need water, removing dry leaves or preparing a plant pot.
- Helping with household tasks: setting the table, putting away clothes, organising objects or preparing materials for an activity.
- Taking part in a cultural activity: visiting an exhibition, attending a workshop, watching a film or discussing a news story.
- Using digital tools: making a video call, searching for a song or looking at a photograph with assistance.
- Planning an outing: choosing the destination, checking what is needed and deciding on a time.
- Practising adapted movement: walking, dancing or performing simple exercises, following professional guidance when necessary.
- Taking part in social activities: having conversations, attending family gatherings or helping with an association.
The person can also continue participating in tasks they used to perform, even if they can no longer complete them independently. For example, they may prepare some ingredients while someone else uses the cooker, or choose their clothes while receiving help to get dressed.
Maintaining this participation allows the person to continue making small decisions and playing an active role in their surroundings. Assistance should be provided with the necessary steps, avoiding taking over the entire task before determining what the person can still do.
Activities for older adults with severe cognitive impairment
Activities for people with severe cognitive impairment should be simple, safe and adapted to their ability to communicate and move. At this stage, the main aim is not to complete a task but to encourage interaction with the environment, participation and well-being.
FFamiliar and pleasant stimuli can be used:
- Listening to familiar music: playing songs associated with meaningful moments, singing softly or following the rhythm with the hands.
- Looking at photographs: showing familiar images without requiring the person to identify everyone or recall specific events.
- Exploring textures: touching fabrics, cushions, clothes or safe objects with different surfaces.
- Using familiar scents: presenting flowers, aromatic plants or familiar foods after checking that they do not cause discomfort.
- Performing assisted movements: slowly moving the hands and arms, holding a soft ball or following a simple rhythm.
- Taking part in familiar routines: helping with personal care, folding a piece of fabric, positioning an object or holding a safe utensil.
- Listening to someone read: reading a short text, prayer, poem or familiar story.
- Receiving pleasant physical contact: holding the person’s hand or giving them a gentle massage if they are comfortable with it.
- Observing the surroundings: sitting near a window, going into a garden or listening to natural sounds.
- Handling safe objects: holding sufficiently large items connected to familiar activities.
Participation may consist of looking, listening, touching or making a small movement. The person does not need to speak or follow complex instructions for the activity to be meaningful.
Their response may take the form of a look, a gesture, a vocalisation or a change in facial expression. These signs can help identify which stimuli generate interest and which should be avoided.
How to adapt exercises and activities without causing frustration
Each activity should be adapted to the person’s abilities, interests and physical condition. The format is also important: some people respond better to written exercises, while others find it easier to work with images, objects or spoken instructions.
To make participation easier:
- Present only one activity at a time and use brief instructions.
- Demonstrate an example and divide complex tasks into smaller steps.
- Offer clues or reduce the number of options when necessary.
- Allow sufficient time for the person to respond.
- Avoid constantly correcting them or focusing only on correct answers.
- End the activity if the person shows signs of tiredness, fear, tension or resistance.
The level of difficulty can be adjusted by reducing the number of items, simplifying the steps or allowing the person to complete only one part of the task. Providing assistance does not mean completing the entire activity on their behalf, but helping them participate within their abilities.
Sessions do not need to have a fixed duration. A short activity that generates interest may be more suitable than a lengthy task that causes tiredness or loss of attention.
It is also advisable to avoid expressions that make the person feel as though they are being tested, such as “you should already know this” or “keep trying until you get it right”. It is better to acknowledge their participation and focus on what they can still do.
Safety must also be considered. Small objects, sharp materials, irritating substances and tasks that present a risk of falling should be avoided.
The National Institute on Aging recommends choosing activities the person can perform, helping them get started and observing whether the activity is causing frustration.
If the impairment progresses, behavioural changes occur or the person experiences problems with mobility, vision, hearing or swallowing, it is advisable to consult a professional. Professional guidance should also be sought when it is unclear how to adjust the difficulty or establish an adapted routine.
Activities as part of comprehensive care
Supporting a person with cognitive impairment should not be limited to completing exercises. It is also important to care for their mobility, diet, rest, social participation and overall health, adapting the support to their needs.
This approach is consistent with the recommendations of the World Health Organization, which includes rehabilitation, physical activity, social participation and cognitive stimulation among the non-pharmacological interventions associated with quality of life and everyday functioning in people with dementia.
In the early stages, this comprehensive care may also include FontUp®, a food supplement formulated with EGCG from green tea extract. Its use should be combined with healthy habits and professional monitoring, and it does not replace exercises or medical treatment.
In this way, exercises and activities become part of a broader approach to care, adapted to each person’s changing needs and condition.
