2). According to Kane and Houston-Vega, Alzheimer's disease is the most common form of dementia and manifests as "an insidious memory impairment, with other possible symptoms including aphasia, apraxia, agnosia, and disturbances in executive functioning" (p. 286).

In a highly multicultural society such as characterizes the United Kingdom today, identifying any relevant cultural factors that must be taken into account when formulating walking regimens as proposed herein. For example, Kane and his colleagues report, "There are differing epidemiological rates for dementia among the various ethno-cultural groups. Additionally, there are differing values, beliefs, behaviors, attitudes, coping strategies, and needs related to Alzheimer's disease and other types of dementia. This is evidenced by an expanding body of literature that describes the effect of mental health concerns, such as dementia, on diverse ethno-cultural groups" (p. 285).

Beyond the challenges to the provision of a cost-effective, community-based walking regimen is the difficulty involved in formulating accurate diagnoses of older adults suffering from dementia. According to Monhan (1993), "It is difficult to accurately assess, diagnose, and treat dementia patients without input from their families. Patients with a suspected dementia often enter the medical system unable to recall the onset or nature of their memory loss. Family members provide useful supplementary data and contextual interpretation documenting the presence and degree of cognitive dysfunction" (p. 123). Despite these obstacles, occupational therapists have a professional and legal obligation to identify such cost-effective initiatives to promote the health and well-being of the patients whenever possible. Indeed, this type of comprehensive and cost-effective support for families and caregivers represents an essential component of modern healthcare services in general and occupational therapy practice in particular and is required by the National Service Framework for Older Adults (Evans & Garner, 2004).

Conclusion

The research showed that dementia is a progressive condition and affects the cognitive functioning of many older adults in the United Kingdom today. The bad news that emerged from the review of the relevant literature was that there are going to be even more older people in the future and it is reasonable to conclude that the incidence of dementia will get worse before it gets better. Other bad news about dementia included the fact that the condition is currently irreversible and a cure continues to be sought. The good news, though, was that there are some cost-effective methods available to clinicians that can provide these older adults with...

The research was also clear in emphasizing the need to carefully assess the individual ability of program participants, as well as to take into account any potential environmental conditions that might represent threats to the safety of the participants. Despite the difficulties involving in formulating accurate diagnoses and assessments of dementia sufferers, family members and other caregivers can provide occupational therapists with some valuable information they can use to fine-tune such programs to the individual needs and capabilities of its participants. The review of the literature also showed that occupational therapists in the United Kingdom have a fundamental moral and professional responsibility to develop such cost-effective initiatives and to ensure they are administered in an appropriate fashion depending on the participants' abilities, needs and expressed individual desires and to ensure that all participants are informed concerning potential hazards involved in such activities to the maximum extent possible. In the final analysis, although there remains a paucity of timely studies concerning the efficacy of walking regimens for older adults with dementia per se, the growing body of evidence concerning the effectiveness of such initiatives for older adults in general suggests that such programs represent a good start to further community-based programs that can improve the quality of life for millions of older adults today.