What is younger onset dementia?
Younger onset dementia is any form of dementia diagnosed before the age of 65. It can be caused by Alzheimer's disease, frontotemporal dementia, vascular dementia, Lewy body disease, alcohol-related brain damage and other conditions. Dementia Australia estimates around 29,000 Australians are living with younger onset dementia in 2026, rising to about 41,000 by 2054.
Because people are younger, diagnosis is often delayed and the impact is wide-reaching: work, driving, finances, parenting and relationships can all be affected at once. Many people also remain physically fit and capable, which is exactly why early therapy can make such a difference.
Why NDIS support matters
People diagnosed before 65 can apply for the NDIS, which is designed to fund supports that build and maintain independence. This is a real advantage. It means occupational therapy and exercise physiology can start early, while the person can still learn and practise new strategies, rather than waiting for a crisis.
What occupational therapy does
A systematic review of home-based OT for people with dementia (20 studies, over 4,300 participants) found improvements in daily living activities in many studies, along with reduced carer burden and greater carer confidence. The most effective programs combined home modifications, task simplification, carer education and problem-solving.
- Routines and memory supports: whiteboards, labelled cupboards, medication systems, phone reminders and simple daily planners
- Task simplification: breaking tasks into steps and setting up the home so the right items are easy to find
- Home safety: stove safety, lighting, wandering risk, falls hazards and bathroom equipment
- Meaningful activity: keeping hobbies, volunteering and social roles going with the right adjustments
- Work and driving: planning a supported transition from work and OT driving assessments when driving safety is in question
- Carer support: teaching family members communication strategies and ways to support without taking over
What exercise physiology does
Regular exercise supports heart health, strength, balance, mood and sleep, all of which matter more when living with dementia. A Cochrane review found promising evidence that exercise programs may improve the ability to perform daily activities in people with dementia, although the evidence quality was low. The same review found no clear effect on cognition, so we focus on what exercise does well: keeping the body capable.
- Strength and balance training to reduce falls risk
- Aerobic exercise for heart health, mood and sleep
- Keeping up familiar sports and activities the person already enjoys
- Simple, consistent routines that are easier to remember
- Involving a partner or support worker so exercise becomes part of the week
Example: A 58-year-old with early Alzheimer's disease has stopped work and lost confidence leaving the house. The OT sets up a visual weekly planner, labels the kitchen and assesses driving safety. The EP starts twice-weekly walking and strength sessions along the local creek trail, the same route each time and trains his wife to join a third walk. Six months on he is walking to the local café on his own with a phone locator for peace of mind.
Why OT and EP work best together
Dementia affects how new information is learned, so consistency matters. When the OT and EP share the same routine, cues and communication style, the person is not trying to follow two different systems. The OT's daily planner includes exercise sessions. The EP uses the same visual cues the OT has set up. Both clinicians keep the carer in the loop and adjust together as needs change.
Support that starts early and adapts over time
Exercare visits at home across Melbourne: exercise physiology in the south-east and east and occupational therapy in the north-east, east and inner suburbs. One NDIS intake form covers both services.
Funding options
If you were under 65 when you applied, the NDIS can fund occupational therapy and exercise physiology. Both are usually funded from your Capacity Building budget, most often under Improved Daily Living Skills (Category 15). Exercise physiology can also be funded under Improved Health and Wellbeing (Category 12). Equipment and home modification recommendations from your OT are funded from your Capital budget.
If dementia is diagnosed after 65, supports are usually accessed through My Aged Care instead. Exercare provides exercise physiology through Support at Home and Medicare Chronic Disease Management plans. Our OT services are available through the NDIS and Support at Home.
Helpful contacts: Dementia Australia's National Dementia Helpline (1800 100 500) and Young Dementia Australia offer free information and support for people with younger onset dementia and their families.
Evidence referenced in this article
- Young onset dementia: the facts. Dementia Australia.
- Raj SE, et al. Home-based occupational therapy for adults with dementia and their informal caregivers: a systematic review. American Journal of Occupational Therapy, 2021.
- Forbes D, et al. Exercise programs for people with dementia. Cochrane Database of Systematic Reviews, 2015.
Written by the Exercare allied health team. This article is general information only and is not a substitute for individual medical advice. Exercare provides mobile exercise physiology and NDIS occupational therapy across south-east and eastern Melbourne.
OT services mentioned in this article:
Adult OT → · Home modifications →
Frequently asked questions
Can people with younger onset dementia get NDIS funding?
Yes. If you apply before age 65 and your dementia causes permanent and significant disability, you can be eligible for the NDIS. It can fund occupational therapy, exercise physiology and other supports.
Does exercise slow down dementia?
The evidence does not show a clear effect on memory or thinking once dementia is established. Exercise may help people keep doing daily activities and supports strength, balance, mood and sleep.
How can an OT help at home?
OTs set up routines and memory aids, simplify tasks, make the home safer and teach carers practical strategies. Research shows home-based OT can improve daily function and reduce carer burden.
What if dementia is diagnosed after 65?
Supports are usually accessed through My Aged Care. Exercare provides exercise physiology through Support at Home and Medicare. Our OT services are available through the NDIS and Support at Home.