What the research actually supports & how therapists can use it responsibly

The question this article answers

Do applied neurology–style interventions (movement, sensory-motor work, dual-task training, cognitive stimulation) have evidence for helping people with Alzheimer’s disease or dementia — and if so, what does “help” really mean?

This question comes up constantly for therapists.

Not from social media.
Not from marketing funnels.

From real families.
Real clients.
Real clinicians who don’t want to overpromise — but also don’t want to do nothing.

So let’s answer it clearly.

The short answer (before we go deeper)

There is no evidence-based drill that cures Alzheimer’s disease or dementia.

But there is strong evidence that structured, non-pharmacological interventions, especially physical activity, cognitive stimulation, dual-task training, music-based interventions, and multisensory approaches — can:

• improve daily function

• reduce agitation and distress

• improve mobility and safety

• support mood and sleep

• improve quality of life

• and, in some cases, modestly improve or stabilize aspects of cognition

This is not fringe neuroscience.

It is supported by World Health Organization guidance, Cochrane reviews, meta-analyses, and randomized controlled trials.

The win in dementia care is not “fixing the disease.”
The win is supporting capacity, function, and regulation with the brain that remains.

What therapists usually mean by “applied neurology drills”

In practice, applied neurology work usually involves:

• movement (gait, balance, strength, coordination)

• sensory input (vision, vestibular, proprioception, rhythm, sound)

• cognitive load (attention, inhibition, memory, dual-tasking)

• reassessment (tolerance, function, behavior)

In dementia care, those same elements already exist under different names:

• exercise programs (aerobic, resistance, balance)

• dual-task functional training (move + think)

• cognitive stimulation therapy (CST)

• music-based interventions

• multisensory stimulation programs

So, yes,  much of what therapists call “applied neurology drills” overlaps directly with evidence-based, non-pharmacological dementia care, as long as it is dosed, progressed, and framed correctly.

The ethical line therapists must not cross

You can ethically say:

• “This may support daily function and mobility.”

• “This may reduce agitation or improve engagement.”

• “This may support cognition or quality of life in some individuals.”

• “This works alongside medical management.”

You should not say:

• “This cures Alzheimer’s.”

• “This reverses dementia.”

• “This removes plaques.”

• “This stops disease progression.”

Not because those ideas are controversial...
....but because they are not supported by evidence.

Global health guidance uses language like support, improve, reduce symptoms, and should be offered...
.....not cure language.

The strongest evidence: physical activity

If a therapist only implemented one intervention for dementia, exercise would be it.

WHO guidance is explicit

The World Health Organization states that physical exercise should be offered to people living with dementia, with:

• 3–4 sessions per week

• 30–45 minutes per session

• sustained over 12+ weeks

This recommendation carries high certainty of evidence.

That alone should shift how therapists view their role.

What exercise improves in Alzheimer’s disease

Meta-analyses and trials consistently show that exercise can improve:

• activities of daily living (ADLs)

• walking tolerance and balance

• functional independence

• mood and engagement

Several 2024 meta-analyses found that physical exercise significantly improves ADLs in Alzheimer’s disease, which is often the most meaningful outcome for families.

Cognitive effects tend to be modest but real, especially in earlier stages, and vary depending on program design.

Why exercise helps the brain

Exercise:

• increases cerebral blood flow

• improves cardiovascular and metabolic health

• increases neurotrophic factors (like BDNF)

• supports brain network efficiency

In some studies, exercise has even been associated with structural brain changes, such as increased hippocampal volume or improved functional connectivity.

This does not mean exercise reverses Alzheimer’s...
....but it does mean the brain remains responsive to input.

Dual-task training: where applied neurology shines

Families rarely complain about memory scores.

They say:

• “He can’t walk and talk at the same time.”

• “She freezes when things get busy.”

• “He falls when he turns or gets distracted.”
  
  

That’s dual-task breakdown.

Research shows that dual-task training...
.... practicing movement while performing a cognitive task can improve:

• gait stability

• attention during movement

• fall risk

• cognitive-motor integration

Randomized trials in mild–moderate dementia show that patients can significantly improve their ability to walk while thinking after structured dual-task training.

Some studies even suggest added benefits beyond exercise alone when cognitive load is included.

This is not “brain games.”
It is training real-life bandwidth.

Cognitive Stimulation Therapy (CST): the most established dementia protocol

If therapists are asking, “Is there a real protocol for this?” — CST is the best answer.

Cognitive Stimulation Therapy is a structured, manualized program designed specifically for mild–moderate dementia.

Research shows CST can improve:

• global cognition

• quality of life

• mood and affective symptoms

• caregiver burden

Cochrane reviews and recent meta-analyses support CST as one of the most evidence-backed non-drug interventions for dementia.

From an applied neurology lens, CST is simply structured cognitive + social stimulation delivered consistently.

Music and multisensory interventions: regulation before performance

Dementia care is not only cognitive.

It is emotional.
Behavioral.
Autonomic.

Music-based interventions have strong evidence for reducing agitation in dementia, with moderate effect sizes in meta-analyses.

Multisensory approaches (music, touch, scent, light, familiar objects) can:

• reduce distress

• increase engagement

• improve participation in care

• support comfort in later stages

These interventions don’t “train cognition” in the traditional sense...
they reduce threat load, which often makes cognition and function more accessible.

Sometimes the most effective drill is making the nervous system feel safe.

What success actually looks like (and should be documented as)

For therapists, success should be defined as:

Function and safety

• gait speed

• transfers

• stair tolerance

• fall frequency

• ADL independence

Regulation and behavior

• agitation frequency

• participation in care

• sleep quality

Engagement and quality of life

• time-on-task

• social interaction

• mood

Cognition (measured carefully)

• modest improvement or stabilization

• not reversal or cure

This framing protects clinicians ethically and aligns with the evidence.

A simple applied neurology framework for dementia care

Think lanes, not magic bullets.

Lane 1: Aerobic capacity
Walking, cycling, intervals, scaled for safety.

Lane 2: Strength for ADLs
Sit-to-stand, step-ups, carries, supported loading.

Lane 3: Balance and gait
Weight shifts, turns, obstacle navigation.

Lane 4: Dual-task training
Move + name, move + count, move + respond.

Lane 5: Regulation tools
Music, rhythm, breath pacing, sensory anchors.

Not every lane is used every session.
But over time, all lanes matter.

What therapists should say when families ask, “Will this help Alzheimer’s?”

An ethical, evidence-aligned response:

“These sessions are supportive. They don’t treat or cure Alzheimer’s disease.
What we can do is support function, safety, regulation, and quality of life using evidence-based movement and cognitive strategies. Many people see meaningful improvements in daily function and engagement, depending on stage and consistency.”

That language is accurate and defensible.

Key takeaway for Next Level Neuro clinicians

Dementia reduces neurological capacity.
It does not eliminate it.

Applied neurology–informed strategies help therapists:

• work within the remaining capacity

• reduce nervous system threat

• support real-world function

• improve quality of life

That is meaningful care, even when a cure is not possible.

Frequently Asked Questions (FAQ)

Can these drills cure Alzheimer’s or dementia?

No. There is no evidence that applied neurology, exercise, or cognitive drills cure dementia.

Why use them at all?

Because they can improve function, reduce distress, improve safety, and enhance quality of life.

Is there scientific evidence behind this?

Yes. WHO guidance, Cochrane reviews, meta-analyses, and RCTs support physical activity, CST, dual-task training, music, and multisensory interventions.

Are these appropriate at all stages?

Yes — when scaled appropriately. Complexity decreases as disease severity increases.

Should therapists work alone with dementia clients?

No. Dementia care should be collaborative and integrated with medical providers and caregivers.

Sources & References

1. World Health Organization (WHO) – Non-pharmacological interventions for dementia
   https://www.who.int/teams/mental-health-and-substance-use/treatment-care/mental-health-gap-action-programme/evidence-centre/dementia/cognitive-and-psychosocial-interventions

2. Chen Y. et al. (2024). Effects of physical exercise on ADLs in Alzheimer’s disease. Journal of Alzheimer’s Disease.
   https://pmc.ncbi.nlm.nih.gov/articles/PMC11631704/

3. Li X. et al. (2024). Exercise interventions and daily living ability in Alzheimer’s disease. Frontiers in Aging Neuroscience.
   https://www.frontiersin.org/articles/10.3389/fnagi.2024.1391611

4. Groot C. et al. (2025). Aerobic exercise and cognition in Alzheimer’s disease. BMJ Open.
   https://bmjopen.bmj.com/content/15/1/e090623

5. Montero-Odasso M. et al. (2025). Dual-task training in cognitive impairment. Gait & Posture.
   https://www.sciencedirect.com/science/article/abs/pii/S1568163725000017

6. Orrell M. et al. (2024). Effectiveness of Cognitive Stimulation Therapy. Aging & Mental Health.
   https://pubmed.ncbi.nlm.nih.gov/38636561/

7. Woods B. et al. (2023). Cognitive stimulation for dementia. Cochrane Database of Systematic Reviews.
   https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005562.pub3

8. Zhang Y. et al. (2025). Music therapy and agitation in dementia. Journal of Alzheimer’s Disease.
   https://pubmed.ncbi.nlm.nih.gov/41046571/

9. Ueda T. et al. (2017). Effects of music on agitation in dementia. Aging & Mental Health.
   https://pmc.ncbi.nlm.nih.gov/articles/PMC5432607/