Effectiveness of an individualized functional training program on affective disturbances and functional skills in mild and moderate dementia--a randomized control trial.
OBJECTIVE
We reported the findings of a randomized controlled trial (RCT) to examine the effects of an individualized functional enhancement program (FEP) on functional skills and mood symptoms in mild and moderate dementia.


METHODS
74 Chinese older persons with dementia were recruited into a skills training program by occupational therapists (OT). Thirty seven subjects were trained with an individualized selection of daily activities (FEP Intervention, I); 37 were trained with general occupational therapy (Control, C). The FEP comprised of twice weekly group sessions of skills training and problem solving using cognitive behavioral approach.


RESULTS
At 1 month after completion of program, both I and C subjects showed an improvement in process skills of the assessment of motor and process skills (AMPS)(paired t-tests, p < 0.05). At 4 months post-program, the I group showed a further reduction of cornell scale for depression in dementia (CSDD) scores (paired t-test, p = 0.02); Apathy improved at 1 month post-training (p = 0.04), but deteriorated at 4 months (p = 0.01). Group differences in changes of mood and functional scores were not significant (ANVOCA, p > 0.05).


CONCLUSIONS
The findings suggested a potential benefit for individualized occupational therapy. It should be tailor made with individual needs and continued for sustained effectiveness.
Lam
Linda C W
LC
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong. cwlam@cuhk.edu.hk
Lui
Victor W C
VW
Luk
Daisy N Y
DN
Chau
Rachel
R
So
Clifton
C
Poon
Vickie
V
Tam
Peter
P
Ching
Raymond
R
Lo
Henry
H
Chiu
Julian
J
Fung
Ada
A
Ko
Flora S L
FS
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D057565:Apathy; D003072:Cognition Disorders / Q000175:diagnosis / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy; D003704:Dementia / Q000523:psychology* / Q000534:rehabilitation*; D003866:Depressive Disorder / Q000175:diagnosis / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis* / Q000534:rehabilitation; D009048:Motor Skills / Q000502:physiology; D009483:Neuropsychological Tests; D015397:Program Evaluation; D011597:Psychomotor Performance