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  2. Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial

Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial

Objective To determine the effectiveness of community based occupational therapy on daily functioning of patients with dementia and the sense of competence of their care givers.

Design Single blind randomised controlled trial. Assessors were blinded for treatment allocation.

Setting Memory clinic and day clinic of a geriatrics department and participants' homes.

Participants 135 patients aged ≥65 with mild to moderate dementia living in the community and their primary care givers.

Interventions 10 sessions of occupational therapy over five weeks, including cognitive and behavioural interventions, to train patients in the use of aids to compensate for cognitive decline and care givers in coping behaviours and supervision.

Main outcome measures Patients' daily functioning assessed with the assessment of motor and process skills (AMPS) and the performance scale of the interview of deterioration in daily activities in dementia (IDDD). Care giver burden assessed with the sense of competence questionnaire (SCQ). Participants were evaluated at baseline, six weeks, and three months.

Results Scores improved significantly relative to baseline in patients and care givers in the intervention group compared with the controls (differences were 1.5 (95% confidence interval 1.3 to 1.7) for the process scale; −11.7 (−13.6 to −9.7) for the performance scale; and (11.0; 9.2 to 12.8) for the competence scale). This improvement was still significant at three months. The number needed to treat to reach a clinically relevant improvement in motor and process skills score was 1.3 (1.2 to 1.4) at six weeks. Effect sizes were 2.5, 2.3, and 1.2, respectively, at six weeks and 2.7, 2.4, and 0.8, respectively, at 12 weeks.

Conclusions Occupational therapy improved patients' daily functioning and reduced the burden on the care giver, despite the patients' limited learning ability. Effects were still present at 12 weeks, which justifies implementation of this intervention.

Trial registration Clinical Trials NCT00295152.

Access source material through DOI
Additional Titles
BMJ

Key Information

Type of Reference
Jour
Type of Work
Randomized controlled trial
ISBN/ISSN
0959-8138
Resource Database
Hmic
Publication Year
2006
Issue Number
7580
Volume Number
333
Start Page
1196
Language
English