Home-based occupational therapy may help reduce behavioral problems in dementia patients, resulting in a decrease in the amount of informal care needed and easing the burdens of caregivers, according to a new French study published in the Journal of Alzheimer’s Disease.
Within the last several years, home-based occupational therapy has been implemented throughout France with the use of specialized Alzheimer teams. Although the efficacy of occupational therapy has been demonstrated in some clinical trials, whether or not it is effective under routine care conditions was still unknown and is the focus of the new study.
The study was conducted using a network of 16 specialized Alzheimer teams in Aquitaine, France and was supported by the regional agency of health (Agence Régionale de la Santé d’Aquitaine). It included 421 dementia patients who had been referred to occupational therapy by their general practitioner or memory clinic.
Researchers studied the clinical evolution of patients from the beginning of the study to the three month follow-up (end of the 15 home sessions) and between the three and six month follow-up (no sessions planned over this timeframe).
The findings show that, over the three month intervention period, occupational therapy significantly reduced patients’ behavioral problems, increased their quality of life, lowered caregivers’ burden, and reduced the need for informal care by caregivers. Cognitive performances remained stable over the six month study period and functional performances remained stable over the three month intervention period but dropped significantly thereafter.
Importantly, patients who had been diagnosed more recently and those with milder cognitive deficits appeared to gain the most benefits from occupational therapy in terms of functional decline and caregivers’ burden decline. These findings suggest that occupational therapy should target early dementia stages in order to optimize its clinical benefits.
In many Western countries, recent national guidelines have aimed at improving home dementia care. This study highlights the strong potential of occupational therapy in terms of patients’ and their caregivers’ well-being. The findings also pave a new pathway for occupational therapy for dementia patients. Indeed, occupational therapy has been conceptualized as a short-term home intervention, but long-term benefits and consequences of disruption are unknown.
“Future studies should explore more in detail which sub-groups of patients could gain more benefits from OT as well as its long-term clinical effects notably on global care quality and users’ satisfaction” said researcher Clément Pimouguet.
Furthermore, strategies aiming to improve the initial benefits of occupational therapy should be promoted. The French research team is planning to conduct a randomized trial that compares the outcome of typical short-term occupational therapy with the outcome of a four month extension of traditional therapy.
Source: Journal of Alzheimer’s Disease