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Benefits of Occupational Therapy in Dementia Patients: Findings from a Real-World Observational Study.
J Alzheimers Dis 2017; 56(2):509-517JA

Abstract

BACKGROUND

There is a growing interest in developing non-pharmacological approaches in dementia. Clinical efficacy of occupational therapy (OT) under routine care conditions has not been investigated yet.

OBJECTIVE

To analyze the short-term effects of OT in patients with dementia; and to identify factors related to greater benefit.

METHODS

Patients referred to OT were evaluated before starting a 3-month intervention and at 3 and 6 months later. Measures included: Mini-Mental State Examination (MMSE), Disability Assessment in Dementia (DAD), Neuropsychiatric Inventory (NPI) Questionnaire, patients' quality of life (EQ 5D-VAS), caregivers' burden (Zarit scale), and amount of informal care. Linear mixed models were used to analyze trajectories of outcomes. Logistic regressions with stepwise descending selection were used to study factors associated with benefits.

RESULTS

421 dementia patients benefited from OT (mean MMSE = 17.3). Patients remained cognitively stable over time. Functional performances also remained stable at 3 months and significantly decreased at 6 months (crude reduction of 2.8 points, p < 0.01). Behavioral troubles were significantly reduced over the intervention period and remained stable after (p < 0.01). Patients' quality of life increased over the 3-month intervention (p = 0.16) and significantly decreased thereafter. Caregivers' burden and informal care significantly decreased over the 3-month intervention and remained stable thereafter. Patients who benefited from OT with regard to function were less educated and had higher cognitive level.

CONCLUSION

OT may be an effective intervention to maintain cognition and functionality and to reduce psychiatric symptoms in dementia patients. Mild stages of dementia could gain more benefits from OT with regard to functional decline.

Authors+Show Affiliations

INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, Bordeaux, France. University Bordeaux, Bordeaux, France.INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, Bordeaux, France. University Bordeaux, Bordeaux, France.INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, Bordeaux, France. University Bordeaux, Bordeaux, France.INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, Bordeaux, France. University Bordeaux, Bordeaux, France. Service de Neurologie, Department of Clinical Neurosciences, CHU Pellegrin, Bordeaux, France.INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, Bordeaux, France. University Bordeaux, Bordeaux, France. INSERM, Clinical Investigation Center - Clinical Epidemiology 1401, Bordeaux, France.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27983551

Citation

Pimouguet, Clément, et al. "Benefits of Occupational Therapy in Dementia Patients: Findings From a Real-World Observational Study." Journal of Alzheimer's Disease : JAD, vol. 56, no. 2, 2017, pp. 509-517.
Pimouguet C, Le Goff M, Wittwer J, et al. Benefits of Occupational Therapy in Dementia Patients: Findings from a Real-World Observational Study. J Alzheimers Dis. 2017;56(2):509-517.
Pimouguet, C., Le Goff, M., Wittwer, J., Dartigues, J. F., & Helmer, C. (2017). Benefits of Occupational Therapy in Dementia Patients: Findings from a Real-World Observational Study. Journal of Alzheimer's Disease : JAD, 56(2), pp. 509-517. doi:10.3233/JAD-160820.
Pimouguet C, et al. Benefits of Occupational Therapy in Dementia Patients: Findings From a Real-World Observational Study. J Alzheimers Dis. 2017;56(2):509-517. PubMed PMID: 27983551.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Benefits of Occupational Therapy in Dementia Patients: Findings from a Real-World Observational Study. AU - Pimouguet,Clément, AU - Le Goff,Mélanie, AU - Wittwer,Jérôme, AU - Dartigues,Jean-François, AU - Helmer,Catherine, PY - 2016/12/17/pubmed PY - 2018/2/24/medline PY - 2016/12/17/entrez KW - Behavioral troubles KW - cognition KW - dementia KW - function KW - non-pharmacological intervention KW - observation study KW - occupational therapy SP - 509 EP - 517 JF - Journal of Alzheimer's disease : JAD JO - J. Alzheimers Dis. VL - 56 IS - 2 N2 - BACKGROUND: There is a growing interest in developing non-pharmacological approaches in dementia. Clinical efficacy of occupational therapy (OT) under routine care conditions has not been investigated yet. OBJECTIVE: To analyze the short-term effects of OT in patients with dementia; and to identify factors related to greater benefit. METHODS: Patients referred to OT were evaluated before starting a 3-month intervention and at 3 and 6 months later. Measures included: Mini-Mental State Examination (MMSE), Disability Assessment in Dementia (DAD), Neuropsychiatric Inventory (NPI) Questionnaire, patients' quality of life (EQ 5D-VAS), caregivers' burden (Zarit scale), and amount of informal care. Linear mixed models were used to analyze trajectories of outcomes. Logistic regressions with stepwise descending selection were used to study factors associated with benefits. RESULTS: 421 dementia patients benefited from OT (mean MMSE = 17.3). Patients remained cognitively stable over time. Functional performances also remained stable at 3 months and significantly decreased at 6 months (crude reduction of 2.8 points, p < 0.01). Behavioral troubles were significantly reduced over the intervention period and remained stable after (p < 0.01). Patients' quality of life increased over the 3-month intervention (p = 0.16) and significantly decreased thereafter. Caregivers' burden and informal care significantly decreased over the 3-month intervention and remained stable thereafter. Patients who benefited from OT with regard to function were less educated and had higher cognitive level. CONCLUSION: OT may be an effective intervention to maintain cognition and functionality and to reduce psychiatric symptoms in dementia patients. Mild stages of dementia could gain more benefits from OT with regard to functional decline. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/27983551/Benefits_of_Occupational_Therapy_in_Dementia_Patients:_Findings_from_a_Real_World_Observational_Study_ L2 - https://content.iospress.com/openurl?genre=article&amp;id=doi:10.3233/JAD-160820 DB - PRIME DP - Unbound Medicine ER -