title: Novel occupational therapy interventions may improve quality of life in older adults with dementia.
abstract: BACKGROUND
  Dementia is a major health problem in advancing age with no definitive treatment. Occupational therapy interventions are recognized strategies in treatment of dementia. Quality of life (QOL) assessment has been reliably used as an objective index of an individual's well being pertaining to interventions in dementia. A randomized controlled trial was conducted to study the effects of a novel occupational therapy program in improving QOL of subjects having mild to moderate dementia.
  
  
  METHODS
  273 subjects older than 60 years were screened. 196 were excluded having cognitive impairment with no dementia (CIND). Remaining 77 subjects after satisfying DSM IV criteria for diagnosis of dementia were included in the study and were randomly assigned to experimental and control groups. Experimental group received a novel occupational therapy regimen along with medical treatment, while control group received only medical treatment for 5 weeks. Outcome measures included standard occupational therapy assessment and WHOQOL-BREF. Subjects were assessed at baseline and post intervention.
  
  
  RESULTS
  The mean age of participants was 69.39 years with male preponderance (80.5% male, 19.5% female). The quality of life (QOL) scores of physical and psychological domain in experimental groups significantly increased from 37.30 ± 5.42 and 45.13 ± 3.52 to 45.43 ± 7.32 and 51.50 ± 6.46 respectively. The QOL scores in social and environmental domains did not change significantly. The QOL scores in control groups declined in all domains with statistical significance found in social and environmental domain. (29.67 ± 4.58 and 38.49 ± 1.77 to 28.45 ± 5.26 and 38.18 ± 2.15 respectively).
  
  
  CONCLUSIONS
  This novel occupational therapy program improved the short term physical performance and psychological well being domain of quality of life in older adults with dementia. An improved physical performance is achieved by physical exercise of novel program and it creates sense of independency, increased motivation, positive outlook and reduced behavioral and psychological symptoms. The long term effects of the intervention can be ascertained in a study with longer period of intervention and follow-up.
  
  
  BACKGROUND
  [CTRI/2014/01/004290].
authors: Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi 110029, India ; Department of Geriatric Mental Health, King George's Medical University, Lucknow, India.
authors: Prakash
authors: P
authors: Kumar
authors: Department of Geriatric Mental Health, King George's Medical University, Lucknow, India.
authors: Sarvada Chandra
authors: SC
authors: Tiwari
authors: Department of Medicine University College of Medical Sciences, Delhi, India.
authors: Ashish
authors: A
authors: Goel
authors: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors: Vishnubhatla
authors: V
authors: Sreenivas
authors: Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
authors: Nand
authors: N
authors: Kumar
authors: Department of Geriatric Mental Health, King George's Medical University, Lucknow, India.
authors: Rakesh Kumar
authors: RK
authors: Tripathi
authors: University of Pittsburgh Medical Center (UPMC) Mercy, Pittsburgh PA 15219, USA.
authors: Vineet
authors: V
authors: Gupta
authors: Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Aparajit Ballave
authors: AB
authors: Dey
keywords: Dementia; Occupational therapy; Quality of life; WHOQOL-BREFF