Standing up for Dementia: exchanging knowledge on developing a patient and professional pathway for physical activity and exercise.

痴呆症目前是一个主要的医疗保健问题。随着人口老龄化，患有痴呆症的人数每年都在增加。这需要付出巨大的人力和财力代价。目前，没有治愈痴呆症的方法，但药物可以帮助延缓疾病的进展，尽管这有不同程度的成功-因此，其他治疗选择，使患者更直接地参与自己的护理是必要的。轻度认知障碍（MCI -定义为认知障碍的水平，虽然明显，但不会对个体的生活产生足够的影响以诊断为痴呆症）被视为痴呆症发展的垫脚石，大量被诊断为痴呆症的人在未来几年内继续发展。痴呆症和MCI的主要症状之一是它对认知过程（例如记忆，规划，感知和定向）的有害影响。在老年人中，研究表明，增加体力活动可以对晚年的认知过程产生有益的影响，这也可能是MCI患者的情况。这也可以起到保护作用，因为年轻时身体活动较多的人随着年龄的增长患痴呆症的风险较小。不幸的是，迄今为止在轻度认知障碍患者群体中进行的许多研究尚未达到高方法标准，通常是由患有不同痴呆症诊断的痴呆症参与者组成的混合群体（不同类型的痴呆症可能会对身体活动产生不同的反应，就像他们对处方药物的反应一样），在不同的护理环境中进行，并且没有可比的认知评估工具。这意味着目前没有针对MCI患者，他们的护理人员和医疗保健专业人员的临床建议，以确定哪种体力活动可能对他们有益，作为当前治疗的替代方案。我们建议制定一项行为改变计划，促进使用体力活动来维持认知功能，并预防有痴呆风险的老年人（MCI患者）的认知能力下降。这将旨在改变MCI患者和负责其护理的医疗保健专业人员的行为，最终目标是将体育活动作为医疗保健“处方”提供给个人。

Dementia is currently a major healthcare problem. As our population ages, the number of people suffering from dementia increases yearly. This comes at both a large human and financial cost. Currently, there is no cure for dementia but medication can help to delay the progress of the disease although this has varying degrees of success - other treatment options which involve the patient more directly in their own care are therefore a necessity. Mild cognitive impairment (MCI - defined as a level of cognitive impairment which although noticeable, does not impact sufficiently on an individual's life to be diagnosed as dementia) is seen a stepping stone in the development of dementia, with large numbers of people diagnosed going on to develop dementia over the coming years. One of the main symptoms of dementia and MCI is the detrimental effect that it has on cognitive processes (for example memory, planning, perception and orientation). Within an elderly age group, research suggests that increasing physical activity can have beneficial effects on cognitive processes in later life and this may also be the case in individuals with MCI. This can also be protective as people who are more physically active in their younger years are at less risk of developing dementia as they get older. Unfortunately, many of the studies carried out so far in groups with MCI have not been performed to a high methodological standard, often with mixed groups of dementia participants with different diagnoses of dementia (it is likely that different types of dementia will respond differently to physical activity, just as they do with medications prescribed), in different care settings and without comparable cognitive assessment tools. This means that there is no current clinical advice for individuals with MCI, their caregivers and healthcare professionals as to what sort of physical activity may be beneficial to them as an alternative to current treatments. We propose to develop a behaviour change program which promotes the use of physical activity to maintain cognitive function and prevent cognitive decline in older adults at risk of dementia (those with MCI). This will aim to change the behaviour of both the individual with MCI and the healthcare professionals responsible for their care with the ultimate aim that physical activity can be offered as a healthcare 'prescription' to individuals.