title: Formulation of evidence-based messages to promote the use of physical activity to prevent and manage Alzheimer's disease.
abstract: The 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.
  
  
  
  A 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.
  
  
  
  The 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.
  
  
  
  Public 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.
authors.affiliation: School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada. kathleen_martin.ginis@ubc.ca.
authors.forename: Kathleen A Martin
authors.initials: KA
authors.lastname: Ginis
authors.affiliation: Department Kinesiology, McMaster University, Hamilton, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Heisz
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada.
authors.forename: John C
authors.initials: JC
authors.lastname: Spence
authors.affiliation: Department Kinesiology, McMaster University, Hamilton, Canada.
authors.forename: Ilana B
authors.initials: IB
authors.lastname: Clark
authors.affiliation: Ontario Brain Institute, Toronto, Canada.
authors.forename: Jordan
authors.initials: J
authors.lastname: Antflick
authors.affiliation: School of Kinesiology and Health Science, York University, Toronto, Canada.
authors.forename: Chris I
authors.initials: CI
authors.lastname: Ardern
authors.affiliation: ParticipACTION, Toronto, Canada.
authors.forename: Christa
authors.initials: C
authors.lastname: Costas-Bradstreet
authors.affiliation: Canadian Society for Exercise Physiology, Ottawa, Canada.
authors.forename: Mary
authors.initials: M
authors.lastname: Duggan
authors.affiliation: Department Kinesiology, McMaster University, Hamilton, Canada.
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Hicks
authors.affiliation: School of Kinesiology and Health Studies, Queen's University, Kingston, Canada.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Latimer-Cheung
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Middleton
authors.affiliation: Ontario Brain Institute, Toronto, Canada.
authors.forename: Kirk
authors.initials: K
authors.lastname: Nylen
authors.affiliation: Canadian Centre for Activity and Aging, Western University, London, Canada.
authors.forename: Donald H
authors.initials: DH
authors.lastname: Paterson
authors.affiliation: School of Health Sciences, University of Northern British Columbia, Prince George, Canada.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Pelletier
authors.affiliation: School of Kinesiology and Health Science, York University, Toronto, Canada.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rotondi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000544:Alzheimer Disease / Q000517:prevention & control* / Q000628:therapy*; D017028:Caregivers; D003071:Cognition; D019468:Disease Management; D055317:Evidence-Based Practice; D015444:Exercise; D006801:Humans
keywords: Activities of daily living; Aging; Cognition; Dementia; Exercise; Fitness; Health promotion; Messaging