Formulation of evidence-based messages to promote the use of physical activity to prevent and manage Alzheimer’s disease

Abstract

BackgroundThe impending public health impact of Alzheimer’s disease is tremendous. Physical activity is a promising intervention for preventing and managing Alzheimer’s disease. However, there is a lack of evidence-based public health messaging to support this position. This paper describes the application of the Appraisal of Guidelines Research and Evaluation II (AGREE-II) principles to formulate an evidence-based message to promote physical activity for the purposes of preventing and managing Alzheimer’s disease.MethodsA messaging statement was developed using the AGREE-II instrument as guidance. Methods included (a) conducting a systematic review of reviews summarizing research on physical activity to prevent and manage Alzheimer’s disease, and (b) engaging stakeholders to deliberate the evidence and formulate the messaging statement.ResultsThe evidence base consisted of seven systematic reviews focused on Alzheimer’s disease prevention and 20 reviews focused on symptom management. Virtually all of the reviews of symptom management conflated patients with Alzheimer’s disease and patients with other dementias, and this limitation was reflected in the second part of the messaging statement. After deliberating the evidence base, an expert panel achieved consensus on the following statement: “Regular participation in physical activity is associated with a reduced risk of developing Alzheimer’s disease. Among older adults with Alzheimer’s disease and other dementias, regular physical activity can improve performance of activities of daily living and mobility, and may improve general cognition and balance.” The statement was rated favourably by a sample of older adults and physicians who treat Alzheimer’s disease patients in terms of its appropriateness, utility, and clarity.ConclusionPublic health and other organizations that promote physical activity, health and well-being to older adults are encouraged to use the evidence-based statement in their programs and resources. Researchers, clinicians, people with Alzheimer’s disease and caregivers are encouraged to adopt the messaging statement and the recommendations in the companion informational resource.

Systematic review of behaviour change techniques to promote participation in physical activity among people with dementia

“…Implications for policy and practice PWD are to be encouraged and facilitated to participate in appropriate forms of physical activity as part of a public health strategy and for PWD to continue to enjoy quality of life (Bowes et al, 2013;Ginis et al, 2017;Nyman & Szymczynska, 2016). Similar to a previous systematic review of qualitative studies conducted with people with physical impairments and mobility limitations (Williams, Ma, & Martin Ginis, 2017), we found that a combination of goal (goal setting (behaviour)), support (social support (unspecified)), and communication (using a credible source) strategies would be promising for promotion of physical activity among PWD.…”

89 Randomised Controlled Trial of the Effect of Tai Chi on Postural Balance of People with Dementia

“…20 Therefore, qualified Tai Chi instructors are encouraged to provide classes for PWD and their family carers so that PWD may also benefit from this exercise for their general health and wellbeing. 57,58…”

Translating the international scientific spinal cord injury exercise guidelines into community and clinical practice guidelines: a Canadian evidence-informed resource

“…The Appraisal of Guidelines Research and Evaluation II (AGREE II) instrument is useful for ensuring rigor and transparency in the clinical guideline development process [13]. An adapted version of AGREE II has been used to guide the development of evidence-informed messages and resources that support delivery of PA guidelines to the general and specific populations, including Canadians with SCI [14][15][16]. This process has not yet been applied to the new SCI scientific exercise guidelines.…”