Occupational Therapy and Interventions for Dementia

The Paper
Ojagbemi, A., & Owolabi, M. (2017). Do occupational therapy interventions improve quality of life in persons with dementia? A meta‐analysis with implications for future directions. Psychogeriatrics, 17(2), 133-141.

The Problem
Dementia affects roughly 5-7% of older adults (age 60+).

It’s associated with disability across all aspects of life, including a high degree of suffering for the patient, their family and social network.

Pharmacological treatment of dementia has so far been a letdown.

Because of this, efforts have been taken towards non-pharmacological treatments to enhance function and well-being (like your work as an OT).

So do interventions aimed to improve function and encourage meaningful occupation help you improve quality of life (QOL) for your patients with dementia?


Study Details

  • Type: Review and meta-analysis of research up to 2015

  • Inclusion: Ten studies included in final analysis

  • Defintion of dementia: Broadly defined by DSM-IV and ICD-10 criteria, or based on best guess

  • Looked at: Any type of literature on dementia and occupational therapy interventions

  • Interventions in the studies:

    • Large variation, different in every study

    • Things like: fun table-top activities or games, environmental modifications, education, training of compensatory techniques, housework, sensory or motor tasks, problem solving, communication training, carer support, physical and cognitive exercise, and various groups


‘OT Intervention’ included both our traditional scope of OT practice, and non-OT specific interventions that were delivered by OTs (eg. caregiver support or coaching).


Results
Overall, this analysis suggests that research on OT intervention shows only a small and non-significant effect on QOL.

However, 3 out of 8 studies showed OT had a significant and positive effect.

The authors also noted that, “The small overall effect of OT interventions for QOL in the present review appears consistent with the fundamental design of OT interventions, which tend to be primarily directed at caregivers”

Key Takeaways
For your work with patients with dementia consider:

  1. Expand your scope of intervention to address caregivers

  2. Advocate for new, high quality research on OT specific interventions for people with dementia (especially if you want to continue to help this population long term)


Clearer research on OT specific intervention and dementia is needed to support stronger results from a meta-analysis approach on this area of practice.

All the more reason for you to have clear and honest discussions with the public and researchers about what your OT work is, and can be!

PS.
Stronger results in research means more support (more funding) of your OT work. So don’t shy away from your inner nerd - use your powerful voice to support research on OT specific interventions!