All of us at Essex Dementia Care believe passionately that activity is essential to health and well-being, and that inactivity is a recipe for ill health and lifestyle disruption. We believe it because we’ve seen it, in our own lives and those of the people with whom we work. But what is the evidence?

Well, a great deal of good quality empirical research has been carried out and published over the last 60 years. Some of it has looked at the negative effects of not engaging in activity, and some at the positive effects of staying active. We have attempted a summary of the findings here.

What happens when we stop engaging in activity?
All physiological systems are affected:

  • Muscles atrophy and joints develop contractures
  • Bone loses calcium leading to osteoporosis and fracture
  • Heart atrophies and blood pressure increases
  • Risk of thrombosis and embolism increases
  • Appetite diminishes
  • Gastro-intestinal movement decreases and constipation increases
  • Potential for urinary infection and incontinence increases
  • Potential for respiratory infection increases
  • Potential for decubitus ulceration increases
  • Sleep pattern is disrupted

It may be interest to know that joint contractures start forming after only 8 hours of inactivity; muscle atrophy, bone loss and heart changes after only a few days of inactivity. There are psychological changes too, some of which also start to take place within 48 hours of inactivity:

  • Decreased alertness
  • Diminished concentration
  • Increased irritability, impatience and hostility
  • Increased tension and anxiety
  • Listlessness and restlessness
  • Depression and lethargy
  • Feelings of oppression
  • Problem-solving difficulties
  • Confusion and disorientation

These changes have been measured and demonstrated in young people and old people, in healthy people and in sick people, in mentally intact people, and in people with dementia. The experience of inactivity has been described in various terms, which are perhaps best summed up as ‘extremely debilitating’. Prolonged inactivity can, and often does, lead to significant physical and psychological ill health.

But what happens when we get active, or remain active?
What about the positives? Well these, as we might expect, manifest themselves as reversals of the above. There are physical changes:

  • Muscle strength and joint mobility increases
  • Bone loss diminishes and healing time of fractures reduces
  • Blood pressure and potential for thrombosis and embolism diminish
  • Appetite increases
  • Gastro-intestinal movement increases and defaecation normalises
  • Continence improves
  • Potential for respiratory disorders decreases
  • Potential for skin disorders decreases
  • Sleep pattern normalises

And there are psychological changes:

  • Smiling and laughing increase
  • Initiation of, and engagement in social interaction increase
  • Alertness to environmental stimuli increases
  • Concentration and memory improve
  • Emotions and humour are more readily expressed
  • Agitation diminishes and relaxation increases
  • Self-assertion increases
  • Ability to give and receive affection increases
  • Daily living function is improved


Activity, older people and dementia: the evidence

There is also a growing body of research supporting the links between activity and healthy ageing. A summary:

  • Social and productive activities lower the risk of mortality as much as conventional fitness activities
  • Increased activity confers greater life satisfaction among the ‘older-old’ even where health is poor
  • In one month theatre arts training improved the cognition and wellbeing of older adults over visual arts training and none
  • Low participation in intellectual, passive and physical activities in mid-life is a risk factor for dementia
  • Frequent participation in mental, social or productive activity is associated with a lower risk of dementia in older people
  • Disengagement from social connections and reduced participation in social activities is a risk factor for cognitive impairment in older people
  • Intellectually engaging activities buffer against longitudinally measured cognitive decline
  • Participation in novelty-seeking and exchange-of-ideas activities is significantly associated with decreased likelihood of developing dementia
  • Psychosocial work factors (especially high challenge and high control activities) have a potentially protective effect against dementia