TT4Change project visit: Changing lives for people with dementia through table tennis in Bulgaria

Last week, the ITTF Foundation’s Social Impact team, represented by Social Impact Coordinator Sara Moamen, traveled to Bulgaria to visit “Table tennis against Alzheimer’s disease: the art of inclusion,” a TT4Change project led by the Foundation Compassion Alzheimer Bulgaria (FCAB). This is the second time the Foundation team has visited the project, which has been running for two years and is nearing the end of the TT4Change cycle. Over three days in Sofia, Kazanlak and Varna, Sara met the coaches, caregivers and players who have proven that a table tennis ball can make a big difference.

Sofia: Where the visit started

The visit started in a warm and welcoming café where FCAB conferences, workshops and social activities take place regularly. It is also a place where older adults come together to connect and spend their time in a meaningful way.

From there, Sara entered the National Sports Academy “Vasil Levski”, home of a table tennis academy headed by coach Martin Romanov. With over a decade of experience combining sports science, rehabilitation and cognitive training, Coach Martin has designed a program that uses table tennis as a tool for both physical and mental stimulation.

Many participants initially doubted whether they would be able to perform the exercises at all. Through patience, repetition, and consistent practice, they not only succeeded, but also built friendships. “The program became a place where they came together as a family,” Sara noted.

When asked what message he would share with families of people with dementia, Coach Martin’s response was simple: “Start playing.” According to him, table tennis can be “better than medicine” when it comes to engagement and overall well-being.

At the FCAB office, Sara met with board member Genoveva Tisheva, project leader Tania Tisheva and two dedicated healthcare providers. “Table tennis gives participants the feeling that success is achievable,” Genoveva explains. The caregivers agreed with her: the sport makes everyone feel included, supports mental health and ensures that participants actively seek out their partners and friends during each session.

Sara also delivered a self-sustainability session for the FCAB team. The session focused on exploring strategies to ensure the long-term continuation and growth of the project beyond the financing period. We discussed opportunities for sustainability, community engagement, partnership development, resource mobilization and ways to build on the project’s achievements to sustain its impact for people with dementia, caregivers and older adults in Bulgaria.

Day one of the visit ended at a table donated by the ITTF Foundation near the “Nativity” church – freely accessible and now a hub for intergenerational play at the heart of the community.

Kazanlak: protection, love and home

In Kazanlak, Sara visited the nursing home where two stars of the World Table Tennis Championships for Parkinson’s reside: Stoil Totev and Veselin Nedeltchev.

Far from a traditional healthcare institution, the center feels like a family home. Its director, Lalka Ivanova, summarized its philosophy in three words: Protection, Love and Home. She spoke passionately about challenging the stereotypes surrounding dementia and the remarkable responses she sees when residents undertake activities related to their habits and interests. One resident who cannot speak lights up when she sees a table tennis ball and instinctively follows it with her eyes.

Sara also met Niya Veleva and Vladimir Trifonov, two young filmmakers who documented Stoil and Veselin’s stories and supported the fundraising campaign to take them to the upcoming World Parkinson’s Table Tennis Championships in China. They shared a telling anecdote: When Veselin heard about the upcoming championship in China, he immediately checked his bank account – a clear sign of his enthusiasm to participate.

While sitting with Stoil himself, Sara heard him recall his championships in Sweden and France in a strikingly vivid way: the quarter-finals, seventh place, the friendships formed along the way. While people with dementia struggle to remember recent events, meaningful experiences persist.

Varna: Table tennis, every day

The last day took Sara to the coast, to the daycare center in Varna. Here, in addition to art and music, the residents play table tennis every day: individual sessions in the morning and a group session every afternoon, with all 20 participants present.

The results speak for themselves. Residents who had never held a racket before and were concerned that they would not be able to hit the ball now grip their rackets properly, bounce the ball and gather around the table. Social worker Anna Deleva described how playing calms participants, improves their coordination and self-confidence, and even surprises their families: Relatives who brought loved ones expecting only basic care see them now become active players.

Physiotherapist Vania Jekova shared one of her favorite observations: every second day, some participants manage to play a full game. And her starting point is clear: the more dementia develops, the more people need to exercise.

The center also extends beyond its walls with the ART Café, a community gathering that invites families to see the impact of the programme, with plans for a fun table tennis day where people with dementia and their families can play together.

One of the participants loves playing so much that, as the social workers say with a smile, she sometimes forgets that she wants to go home.

As the journey continues

With the agreed goal of 235 participants already reached and all planned workshops and conferences delivered, “Table Tennis Against Alzheimer’s: The Art of Inclusion” approaches the end of the project cycle on a strong and heartfelt note. The project team is now finalizing a Guide to Table Tennis for People with Cognitive Difficulties, so that the knowledge gained in Bulgaria can inspire communities far beyond.

From Sofia’s community table to Varna’s daily gatherings, one message resonated through all three cities – the same message Coach Martin shares with every family: “Start playing.”

Read more about our TT4Change projects and how the ITTF Foundation uses table tennis to create social impact (click here).