Abstract

BackgroundDementia is a major health problem in advancing age with no definitive treatment. Occupational therapy interventions are recognized strategies in treatment of dementia. Quality of life (QOL) assessment has been reliably used as an objective index of an individual’s well being pertaining to interventions in dementia. A randomized controlled trial was conducted to study the effects of a novel occupational therapy program in improving QOL of subjects having mild to moderate dementia.Methodology273 subjects older than 60 years were screened. 196 were excluded having cognitive impairment with no dementia (CIND). Remaining 77 subjects after satisfying DSM IV criteria for diagnosis of dementia were included in the study and were randomly assigned to experimental and control groups. Experimental group received a novel occupational therapy regimen along with medical treatment, while control group received only medical treatment for 5 weeks. Outcome measures included standard occupational therapy assessment and WHOQOL-BREF. Subjects were assessed at baseline and post intervention.ResultThe mean age of participants was 69.39 years with male preponderance (80.5% male, 19.5% female). The quality of life (QOL) scores of physical and psychological domain in experimental groups significantly increased from 37.30 ± 5.42 and 45.13 ± 3.52 to 45.43 ± 7.32 and 51.50 ± 6.46 respectively. The QOL scores in social and environmental domains did not change significantly. The QOL scores in control groups declined in all domains with statistical significance found in social and environmental domain. (29.67 ± 4.58 and 38.49 ± 1.77 to 28.45 ± 5.26 and 38.18 ± 2.15 respectively).ConclusionThis novel occupational therapy program improved the short term physical performance and psychological well being domain of quality of life in older adults with dementia. An improved physical performance is achieved by physical exercise of novel program and it creates sense of independency, increased motivation, positive outlook and reduced behavioral and psychological symptoms. The long term effects of the intervention can be ascertained in a study with longer period of intervention and follow-up.Trial registration[CTRI/2014/01/004290]

Highlights

  • Dementia is a common health problem in old age

  • Dementia is caused by several pathological states and there is no definite medical management to reverse or arrest the disease process

  • Computer generated table was formed to allocate the subjects to either the experimental occupational therapy or the control group. In this open label randomized control trial the groups were classified by the level of dementia

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Summary

Introduction

Dementia is a common health problem in old age. It involves progressive cognitive decline beyond normal aging process and leads to progressive deterioration of physical and social functioning. Dementia is caused by several pathological states and there is no definite medical management to reverse or arrest the disease process. This necessitates exploration of non-pharmacological management strategies, to improve functional status and quality of life (QOL) of patients and reduce need for care [2]. Dementia is a major health problem in advancing age with no definitive treatment. Occupational therapy interventions are recognized strategies in treatment of dementia. A randomized controlled trial was conducted to study the effects of a novel occupational therapy program in improving QOL of subjects having mild to moderate dementia

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