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Mental well-being evidenced in new resource: link between health and cognitive behaviour in adults

A new resource has been published summarising the evidence on health behaviour and cognitive health in older adults. The new report by Public Health England is designed for use by local authority commissioners and clinical commissioning groups to help identify which interventions to promote cognitive health are most effective and cost effective and to present the barriers and facilitators to change in this population.

The review contains information on effective interventions for multiple health behaviours including reducing alcohol consumption, smoking, improving diet and nutrition, increasing physical activity, cognitive activities and social engagement. For all health behaviours the report outlines the evidence on its impact on cognitive health, interventions to improve health behaviours and barriers and facilitators that may affect the intervention.

Physical inactivity increases the risk of dementia and therefore encouraging, enabling and supporting everyone to build physical activity into their daily lives is a concrete step towards reducing that risk. Aerobic training, ‘flexi-tone’ training, supervised aerobic training and walking were found to be effective intervention in older adults. However, evidence is lacking to identify the minimum dose of exercise required to improve cognitive health.

Key findings: Physical activity
Physical activity can offer small benefits to brain health yet evidence on how much activity is required to produce this effect is lacking.
Public health messages should be aimed at promoting acceptable levels of physical activity above normal daily activities in older adults.
There is strong evidence to suggest that individual or group-based physical activity interventions can lead to increased uptake of physical activity in older adults. Evidence on long-term effectiveness (>2 years) is generally lacking.
Short duration exercise could be effective for increasing physical activity uptake in the frail older population
Interventions delivered via general practices and/or primary care practices are effective for increasing short term uptake of physical activity.
To maintain long-term participation in physical activity, individualised interventions modelled using behavioural theories are more likely to change behaviour.
When designing interventions aimed at increasing physical activity in older adults, considering barriers and facilitators to behaviour change is critical.

The review identified some gaps in the literature. These are:
doses and intensities of interventions that would increase uptake and maintenance of physical activity
we don’t know the minimum required dose of physical activity needed to improve cognitive function in older people
there is no evidence on whether or not physical activity can prevent/delay onset of dementia
few reviews reported findings from studies with disadvantaged populations.