title: An occupation-based strategy training approach to managing age-related executive changes: a pilot randomized controlled trial.
abstract: OBJECTIVE
  To determine the feasibility of recruitment and retention of healthy older adults and the effectiveness of an intervention designed to manage age-related executive changes.
  
  
  METHODS
  A pilot randomized controlled trial.
  
  
  METHODS
  Research centre and participants' homes.
  
  
  METHODS
  Nineteen healthy, community dwelling older adults with complaints of cognitive difficulties and everyday problems, but no evidence of mild cognitive impairment, dementia or depression on objective testing.
  
  
  METHODS
  Seventeen hours of group and individual training. Participants in the experimental arm received education about self-management, successful aging and an occupation-based meta-cognitive strategy-training program. Participants in the control arm received education about brain health and participated in cognitively stimulating exercises.
  
  
  METHODS
  Changes on untrained, everyday life goals were identified using the Canadian Occupational Performance Measure. Generalization of benefits was measured using the Stanford Chronic Disease Questionnaire, general self-efficacy and changes in executive function (Delis-Kaplan Executive Function System Tower Test, Word Fluency and Trail-Making Test).
  
  
  RESULTS
  20% (19/96) of healthy older adults approached were eligible, consented and were enrolled in the study, 90% (17/19) were retained to three-month follow-up. Participants in the experimental arm reported significantly more improvement on untrained goals (11/22 compared with 9/46, χ(2)=4.92, p<0.05), maintenance of physical activity (p<0.05) and better preparation for doctors' visits (p<0.05) relative to the control group. There were no significant between group differences on objective measures of executive function.
  
  
  CONCLUSIONS
  These data support the feasibility of a larger trial where a sample of 72 (36 participants in each arm) would be required to confirm or refute these findings.
authors.affiliation: 1Rotman Research Institute, Baycrest Centre, Toronto, ON, Canada.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Dawson
authors.forename: Julie
authors.initials: J
authors.lastname: Richardson
authors.forename: Angie
authors.initials: A
authors.lastname: Troyer
authors.forename: Malcolm
authors.initials: M
authors.lastname: Binns
authors.forename: Amanda
authors.initials: A
authors.lastname: Clark
authors.forename: Helene
authors.initials: H
authors.lastname: Polatajko
authors.forename: Gordon
authors.initials: G
authors.lastname: Winocur
authors.forename: Anne
authors.initials: A
authors.lastname: Hunt
authors.forename: Yael
authors.initials: Y
authors.lastname: Bar
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D056344:Executive Function; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D010865:Pilot Projects; D012648:Self Care; D020377:Self Efficacy
keywords: Aging; cognitive impairment; controlled clinical trial; rehabilitation interventions; strategy-training