Strength Training to Improve Balance and Reduce the Risk of Dementia

Most people think of strength training as something for athletes or gym-goers. But for anyone over 60, it might be one of the most important things you can do — not just for your muscles, but for your brain.

The balance connection

Your ability to stay steady on your feet depends heavily on something called proprioception — your body's sense of where it is in space. It's what lets you walk without looking at your feet, step off a curb without stumbling, or recover when you trip on a rug.

As we age, proprioception naturally declines. A large review found that when proprioceptive input was disrupted, balance was significantly impaired across every measurement — and older adults who had previously fallen were affected even more [1].

The good news: strength training directly improves this. Stronger muscles respond faster. Better proprioception means better balance. And better balance means fewer falls.

The gold-standard research — a Cochrane review of 108 studies involving over 23,000 people — found that programs combining balance exercises with resistance training reduced falls by 34% [2]. Programs that specifically challenged balance for more than 3 hours per week achieved a 39% reduction.

The brain connection

Here's where it gets really interesting. A landmark report in The Lancet identified 14 modifiable risk factors for dementia — and physical inactivity is one of them. Together, these factors may account for up to 45% of dementia cases worldwide [3].

The largest study on exercise and Alzheimer's risk — covering 1.45 million people — found that high levels of physical activity reduced the risk by 26%. For adults over 75, the reduction was even greater: 43% [4].

And this isn't just about walking or cardio. A review of studies specifically looking at older adults with mild cognitive impairment found that resistance training produced large improvements in cognitive function — comparable to aerobic exercise [5].

Why strength training works for the brain

When you exercise — particularly resistance training — your body produces more of a protein called BDNF (brain-derived neurotrophic factor). Think of it as fertiliser for brain cells. It supports the growth of new neurons, strengthens connections between existing ones, and is particularly active in the hippocampus — the part of the brain responsible for memory [6].

What this looks like in practice

You don't need a gym. The WHO and Canadian guidelines recommend [7, 8]:

Simple exercises like chair stands, calf raises, single-leg balance holds, and wall push-ups — done consistently — can make a meaningful difference. Start with what you can manage and build gradually.

It's not about hitting fitness goals. It's about maintaining the strength and balance that keep you independent — and protecting your brain while you're at it.

References

1. Aflalo J, et al. Experimental Gerontology. 2025;213:112976.

2. Sherrington C, et al. Cochrane Database of Systematic Reviews. 2019;1:CD012424.

3. Livingston G, et al. The Lancet. 2020;396(10248):413–446.

4. Jiang Y, et al. Journal of Neurology. 2025;272(4):256.

5. Akalp K, et al. Archives of Gerontology and Geriatrics. 2024;126:105541.

6. Setayesh S, Mohammad Rahimi GR. Geriatric Nursing. 2023;54:23–31.

7. Bull FC, et al. British Journal of Sports Medicine. 2020;54(24):1451–1462.

8. Ross R, et al. Applied Physiology, Nutrition, and Metabolism. 2020;45(10 Suppl 2):S57–S102.

This article is for informational purposes only and does not constitute medical advice. Please consult your healthcare provider before starting a new exercise program.