Occupational therapy fails to slow functional decline in Alzheimer’s disease
medwireNews: The addition of 2 years of in-home occupational therapy to collaborative care does not provide functional benefits for patients with Alzheimer’s disease.
The research, published in the Annals of Internal Medicine, showed a similar decline in Alzheimer’s Disease Cooperative Study Group Activities of Daily Living Scale (ADCS ADL) scores over a 24-month period for 89 patients receiving standard collaborative care and 91 receiving additional occupational therapy.
At the 2-year point, the difference in average ADCS ADL scores between the two groups was a nonsignificant 2.34, with scores on the Short Physical Performance Battery and Short Portable Sarcopenia Measure also similar.
Long-term home-based occupational therapy is not currently standard of care for older adults, and the researchers say that“[f]rom both clinical and policy perspectives, the present study does not provide clear evidence to support a change in current clinical practice or policy coverage.”
The in-home occupational therapy was delivered in 24 sessions over 2 years and aimed to support and augment self-care functioning based on goals established with the patient and their carer.
Christopher Callahan (Indiana University Center for Aging Research, Indianapolis, USA) and co-researchers propose that the intervention may have been “less effective than anticipated,” because participants were unable to learn the recommended tasks and activities or because occupational therapy, although necessary, may be insufficient to slow the rate of functional decline.
They conclude: “If the gradual functional decline attributable to Alzheimer disease is irreversible, a new generation of assistive devices, home modifications, community services, and technologies is needed to make longer-term support in the home a practical reality for patients and families.”
By Lucy Piper
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