认知衰退老年人非药物干预临床实践指南:身体活动

Clinical Practice Guideline on Non-pharmacological Interventions for Older Adults with Cognitive Dysfunction:Physical Activity

认知衰退是指一种或多种认知域的功能受损,多以老年人为主要发病人群。依据认知功能损害的程度,主要包括主观认知下降(SCD)、轻度认知障碍(MCI)和痴呆。SCD和MCI人群具有较高的痴呆进展风险,严重影响患者生活质量,给家庭和社会造成了巨大负担。大量研究证明,身体活动是认知衰退的有效非药物干预方式之一。但是,目前认知衰退身体活动干预方案尚无统一标准,且尚无考虑中国认知衰退老年人价值观和偏好的相关身体活动指南,导致证据的传播与应用在一定程度上受到阻碍。本指南旨在基于现有循证证据,并考虑中国认知衰退老年人的价值观和偏好,依据推荐意见评估、制定及评价(GRADE)分级体系制订适合中国国情的《认知衰退老年人非药物干预临床实践指南:身体活动》。最终形成了针对认知衰退老年人身体活动的8条推荐意见,以期能够降低认知衰退发生率,阻止或延缓认知衰退向痴呆的发生发展。

Cognitive dysfunction refers to the functional impairment in one or more cognitive domains,mostly occurs in older adults.Cognitive dysfunction can commonly be divided into subjective cognitive decline(SCD),mild cognitive impairment(MCI)and dementia,depending on the degree of cognitive impairment.People with SCD or MCI have a higher risk of dementia,which seriously affects their quality of life,and imposes a huge burden on families and society.Numerous studies have demonstrated that physical activity is one effective non-pharmacological intervention for cognitive dysfunction,but there are no uniform standards for physical activity programs for cognitive dysfunction worldwide,and China still has no physical activity guidelines based on the values and preferences of older adults with cognitive dysfunction,partially impeding the dissemination and application of relevant evidence.In view of this,we developed a guideline containing eight recommendations that is applicable in China,namely the Clinical Practice Guideline on Non-pharmacological Interventions for Older Adults with Cognitive Dysfunction:Physical Activity,by the use of existing evidence,and the Grading of Recommendations,Assessment,Development,and Evaluations(GRADE)framework combined with values and preferences of Chinese older adults with cognitive dysfunction.This guideline will contribute to the reduction of the incidence of cognitive dysfunction,and preventing or slowing the progression of cognitive dysfunction to dementia.