The Contribution of Physical Activity to Social Connectivity and Wellbeing in Older Adults Living with Dementia

该提案旨在更好地了解英国痴呆症友好社区（dfc）中患有痴呆症的成年人进行体育活动的经验、益处和限制。在英国，大约有85万人患有痴呆症，痴呆症每年给英国造成347亿英镑的损失，而且患病率和费用预计还会上升。痴呆症被理解为一种综合征，其表现为一个人的记忆、思维、行为和/或进行日常活动的能力恶化。痴呆症患者被认为具有较高的社会孤立风险，往往感觉与社区没有联系，并且比其他社会群体感到更孤独。这包括痴呆症患者及其照护者，部分原因是与痴呆症相关的污名。大量证据表明，身体活动规划可使痴呆症患者与当地社区保持联系，并改善身心健康。然而，在对老年生活中身体活动的分析中，患有痴呆症的成年人被忽视了，而且身体活动计划的益处范围也没有得到很好的了解。2019年，英格兰体育部制作了一份《痴呆症友好运动和体育活动指南》，该指南指出，尽管有证据表明体育活动对成年痴呆症患者有益，但他们往往觉得自己无法参与体育活动计划。原因越来越被人们所理解，包括获得交通工具、便利的设施（标志、是否有帮手、对痴呆症患者友好的设计、能够满足特定的身体和认知需求），以及他们有信心不会被工作人员和公众羞辱或排斥。改善身体活动规划有可能通过挑战痴呆症的污名，使痴呆症患者的生活正常化；使痴呆症患者能够选择自己的生活方式；促进包容和与社区的联系感；改善痴呆症患者的福祉。英国是少数几个制定了到2020年半数以上人口将生活在发展中国家（DFC）这一政策的国家之一，这一目标正在实现。发展中国家发展中国家是当地人民和组织之间的合作，通常有地理上的定义，被正式承认致力于促进对痴呆症的认识和纳入痴呆症患者的共同目标。对发展中国家发展中国家的一项评估表明，虽然大多数发展中国家发展中国家都包括身体活动规划，但这些规划往往是临时性的，并受到地点、交通基础设施和人们是否了解现有资源的限制。该研究将重点关注发展中国家如何促进人们参与体育活动。在研究人员早期工作的基础上，该项目将开始对英国各地多达50个DFC进行调查，以绘制DFC内组织和促进的体育活动范围，哪些有效，以及挑战和障碍是什么。它将采取后续行动，对三个发展中国家进行详细的案例研究，以了解如何在当地社区内识别痴呆症患者，并使其能够获得和参加身体活动规划。该研究旨在更好地了解如何满足痴呆症患者不断变化的需求，以及体育活动如何促进包容和参与，以便为发展中国家提供将体育活动纳入其服务的最佳方式。在设计、数据收集和传播方面，研究将由痴呆症患者提供信息，并包括痴呆症患者。研究小组将发表一份关于他们的研究结果的报告，该报告将通过多个网站（当地和全国）公开发布，并且还将通过在一个DFC和当地痴呆症团体的当地博物馆和图书馆的活动来测试传播他们研究结果的创新方法。

This proposal aims to better understand the experiences, benefits, and constraints on provision, of physical activity for adults living with dementia in Dementia Friendly Communities (DFCs) in England. There are approximately 850,000 people living with dementia in the UK and dementia costs the UK £34.7bn p.a., with prevalence and costs predicted to rise. Dementia is understood as a syndrome in which there is deterioration in a person's memory, thinking, behaviour and/or ability to perform everyday activities. People affected by dementia are identified as having a higher risk of being socially isolated, often do not feel connected with their communities, and feel more lonely than other social groups. This includes people living with dementia and their carers, and is attributed, in part, to the stigma associated with dementia. There is considerable evidence that physical activity programmes can enable people living with dementia to stay connected with their local communities and achieve improved physical and mental health. However, adults living with dementia have been neglected in analyses of physical activity in later life, and the range of benefits of physical activity programmes are not well understood. In 2019, Sport England produced a Dementia Friendly Sport and Physical Activity Guide which indicates that, while there is evidence of the benefits of physical activity for adults living with dementia, they often do not feel able to participate in physical activity programmes. The reasons are increasingly well understood and include access to transport, facilities that are enabling (signage, availability of helpers, dementia friendly design, ability to accommodate specific physical and cognitive needs) and having confidence that they will not be stigmatised or excluded by staff and members of the public. Improved physical activity programmes have the potential to normalise living with dementia by challenging the stigma of the disease; enabling people affected by dementia to make choices about their lifestyles choice; promoting inclusion and a sense of connection with their communities; and improving the wellbeing of people living with dementia.England is one of the few countries to have as policy that over half of the population will be living in a DFC by 2020 - a target that is being met. DFCs are collaborations of local people and organisations, often geographically defined, formally recognised as working to a common aim of promoting dementia awareness and inclusion of people affected by dementia. A national evaluation of DFCs identifies that while most DFCs include physical activity programmes, these are often ad hoc and constrained by location, transport infrastructure and people knowing what is available. The research will focus on how DFCs promote engagement with physical activities. Building on earlier work of the researchers, the project will commence with a survey of up to 50 DFCs from across England to map the range of physical activities organised and facilitated within the DFC, what works, and what are the challenges and barriers. It will follow up with a detailed case study of three DFCs to understand how people affected by dementia are identified within local communities and enabled to access and join physical activity programmes. The research aims to better understand how the changing needs of people affected by dementia are addressed and how physical activities promote inclusion and participation, to inform DFCs of the best ways to incorporate physical activity in their provision. The research will be informed by, and inclusive of, people living with dementia in the design, data collection and dissemination. The research team will publish a report on their findings that will be made publicly available via multiple websites (locally and nationally), and will also test innovative ways to disseminate their findings via activities in local museums and libraries in one DFC and local dementia groups.