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Preventive Occupational Therapy in Elderly Patients
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Am Fam Physician. 1998 Jun 1;57(11):2816.
It is projected that more than 17 percent of the American population will be 65 years of age or older by the year 2020, compared with about 13 percent in 1995. If current health trends persist, the longer life spans will include poor general health and a lower quality of life. Clark and colleagues evaluated the effectiveness of a preventive occupational therapy program in maintaining physical health, daily functioning and general well-being in the elderly.
The study participants were at least 60 years old, had the capacity to benefit from occupational therapy and lived independently. Patients were recruited at different times of the year to minimize any seasonal effects on the study and to prevent participant interaction. All participants completed a questionnaire on demographic information, followed by a medical history and a physical examination. Participants were then randomized to one of three groups for the nine-month study: a nontreatment control group, an activity (“social”) group and an occupational therapy group. Participants in the occupational therapy and social groups were asked not to discuss their treatment with anyone in the other groups. The occupational therapy group attended both didactic and experiential sessions that focused on the selection of meaningful activities that would result in a healthier, more satisfying lifestyle. Each participant was asked to assess the effect of specific activities on his or her personal life, including exercise, nutrition, joint protection and the use of assistive devices. Participants attended two hours of group therapy and nine hours of individual therapy each week. The social group encouraged interaction among members, such as community outings, craft projects and dances. The control group had no interventions. After the nine-month study period, participants completed another questionnaire on health, life satisfaction, symptoms of depression, and physical and social function.
Of the 361 study subjects, 122 were in the occupational therapy group, 120 in the social group and 119 in the control group. Baseline demographic parameters and health status were similar across all three groups. Participants in the occupational therapy group showed significant improvement in functional status scores, specifically in social performance and life satisfaction. Other areas of improvement in this group included perception of pain, physical functioning, and perception of general health and mental health. The other two groups showed declines in these areas over the duration of the study.
The authors conclude that the adage “keeping busy keeps you healthy” is not necessarily true for seniors. Rather, participants in the occupational therapy group were helped to form a daily routine that was health promoting and meaningful. The results of this study suggested that preventive occupational therapy programs may be a component of “successful aging.”
Clark F, et al. Occupational therapy for independent-living older adults. A randomized controlled trial. JAMA. October 22, 1997;278:1321–6.
Copyright © 1998 by the American Academy of Family Physicians.
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