title: Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: results of the Well Elderly 2 Randomised Controlled Trial.
abstract: BACKGROUND
  Older people are at risk for health decline and loss of independence. Lifestyle interventions offer potential for reducing such negative outcomes. The aim of this study was to determine the effectiveness and cost-effectiveness of a preventive lifestyle-based occupational therapy intervention, administered in a variety of community-based sites, in improving mental and physical well-being and cognitive functioning in ethnically diverse older people.
  
  
  METHODS
  A randomised controlled trial was conducted comparing an occupational therapy intervention and a no-treatment control condition over a 6-month experimental phase. Participants included 460 men and women aged 60-95 years (mean age 74.9 ± 7.7 years; 53% <$12000 annual income) recruited from 21 sites in the greater Los Angeles metropolitan area.
  
  
  RESULTS
  Intervention participants, relative to untreated controls, showed more favourable change scores on indices of bodily pain, vitality, social functioning, mental health, composite mental functioning, life satisfaction and depressive symptomatology (ps<0.05). The intervention group had a significantly greater increment in quality-adjusted life years (p<0.02), which was achieved cost-effectively (US $41218/UK £24868 per unit). No intervention effect was found for cognitive functioning outcome measures.
  
  
  CONCLUSIONS
  A lifestyle-oriented occupational therapy intervention has beneficial effects for ethnically diverse older people recruited from a wide array of community settings. Because the intervention is cost-effective and is applicable on a wide-scale basis, it has the potential to help reduce health decline and promote well-being in older people. Trial Registration clinicaltrials.gov identifier: NCT0078634.
authors.affiliation: Division of Occupational Science and Occupational Therapy, School of Dentistry, University of Southern California, 1540 Alcazar Street, CHP 133, Los Angeles, CA 90089-9003, USA. fclark@usc.edu
authors.forename: Florence
authors.initials: F
authors.lastname: Clark
authors.forename: Jeanne
authors.initials: J
authors.lastname: Jackson
authors.forename: Mike
authors.initials: M
authors.lastname: Carlson
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Chou
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Cherry
authors.forename: Maryalice
authors.initials: M
authors.lastname: Jordan-Marsh
authors.forename: Bob G
authors.initials: BG
authors.lastname: Knight
authors.forename: Deborah
authors.initials: D
authors.lastname: Mandel
authors.forename: Jeanine
authors.initials: J
authors.lastname: Blanchard
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Granger
authors.forename: Rand R
authors.initials: RR
authors.lastname: Wilcox
authors.forename: Mei Ying
authors.initials: MY
authors.lastname: Lai
authors.forename: Brett
authors.initials: B
authors.lastname: White
authors.forename: Joel
authors.initials: J
authors.lastname: Hay
authors.forename: Claudia
authors.initials: C
authors.lastname: Lam
authors.forename: Abbey
authors.initials: A
authors.lastname: Marterella
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology; D057186:Comparative Effectiveness Research; D018592:Cross-Over Studies; D005260:Female; D015577:Geriatric Assessment; D015438:Health Behavior / Q000208:ethnology; D006293:Health Promotion / Q000191:economics*; D006299:Health Services for the Aged / Q000191:economics*; D006305:Health Status Indicators; D006801:Humans; D008019:Life Style / Q000208:ethnology; D015141:Los Angeles; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009788:Occupational Therapy / Q000191:economics* / Q000523:psychology; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012111:Residence Characteristics / Q000706:statistics & numerical data