Document Type : Original Articles

Authors

1 Department of Occupational Therapy, School of Rehabilitation, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran

2 Department of Occupational Therapy, School of Rehabilitation Sciences, Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran

3 Rehabilitation Research Center, Department of Rehabilitation Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

4 Department of Health Technology Assessment, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Background: Dementia is recognized as a neurodegenerative disease that gradually causes serious cognitive, motor, and functional impairments in affected individuals. This study explored the impact of a meaningful task-oriented intervention on independence in activities of daily living, cognitive status, and physical abilities, including gait speed and balance, among elderly patients diagnosed with mild to moderate dementia.
Methods: In this randomized controlled trial, 40 participants aged 60-70, with a Functional Assessment Staging Tool (FAST Scale) score of 1-5, were recruited. They were randomly assigned to either a control group (n=20) receiving standard care, including medication and routine consultation, or an intervention group (n=20) receiving standard care along with eight 45–60-minute sessions of task-oriented interventions. These interventions were centered around familiar daily life activities in the home environment and were conducted twice a week. The primary outcome measure was the participants' independence in activities of daily living, assessed using the Barthel Index. Secondary outcome measures included cognitive function, evaluated using Addenbrooke’s Cognitive Examination-Revised, and physical performance, assessed through the Timed Up and Go test, 10 Meter Walk Test, and Berg Balance Scale.
Results: The meaningful task-oriented intervention demonstrated significant improvements in independence in activities of daily living (p<0.01) compared to the control group. Additionally, improvements were observed in cognitive function and physical performance, including balance, lower limb strength, and walking speed (p<0.05).
Conclusion: The integration of meaningful task-oriented interventions centered around familiar activities within the home environment appears to offer significant benefits for elderly patients with dementia. By engaging in tasks that resonate with their daily routines, these interventions can support the maintenance of essential skills and foster a sense of independence among affected individuals.
 

Highlights

Malahat Akbarfahimi: googel scholar

Keywords

  1. Kiselica AM, Benge JF. Quantitative and qualitative features of executive dysfunction in frontotemporal and Alzheimer's dementia. Appl Neuropsychol Adult. 2021;28(4):449-63. doi:10.1080/23279095.2019.1652175. [PubMed:31424275].
  2. Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and Management of Dementia: Review. JAMA. 2019;322(16):1589-99. doi:10.1001/jama.2019.4782. [PubMed:31638686].
  3. Huggins M, Pesut B, Puurveen G. Interventions for Caregivers of Older Adults with Dementia Living in the Community: A Rapid Review of Reviews. Can J Aging. 2023:1-9. doi:10.1017/S0714980823000016. [PubMed:36799030].
  4. Cho E, Shin J, Seok JW, Lee H, Lee KH, Jang J, et al. The effectiveness of non-pharmacological interventions using information and communication technologies for behavioral and psychological symptoms of dementia: A systematic review and meta-analysis. Int J Nurs Stud. 2023;138:104392. doi:10.1016/j.ijnurstu.2022.104392. [PubMed:36434931].
  5. Travers C, MacAndrew M, Hines S, O'Reilly M, Fielding E, Beattie E, et al. The effectiveness of meaningful occupation interventions for people living with dementia in residential aged care: a systematic review protocol. JBI Database System Rev Implement Rep. 2015;13(4):87-99. doi:10.11124/jbisrir-2015-2058. [PubMed:26447075].
  6. Bennett S, Laver K, Voigt-Radloff S, Letts L, Clemson L, Graff M, et al. Occupational therapy for people with dementia and their family carers provided at home: a systematic review and meta-analysis. BMJ open. 2019;9(11):e026308-e. doi:10.1136/bmjopen-2018-026308. [PubMed:31719067].
  7. Rostami HR, Akbarfahimi M, Ghaffari A, Kamali M, Rassafiani M. Relationship between Work-Related Quality of Life and Job Satisfaction in Iranian Occupational Therapists. Occup Ther Int. 2021;2021:6692752. doi:10.1155/2021/6692752. [PubMed:34629996].
  8. Strong S, Rigby P, Stewart D, Law M, Letts L, Cooper B. Application of the Person-Environment-Occupation Model: a practical tool. Can J Occup Ther. 1999;66(3):122-33. doi:10.1177/000841749906600304. [PubMed:10462885].
  9. Han A, Radel J, McDowd JM, Sabata D. Perspectives of People with Dementia About Meaningful Activities: A Synthesis. Am J Alzheimers Dis Other Demen. 2016;31(2):115-23. doi:10.1177/1533317515598857. [PubMed:26340962].
  10. Kielsgaard K, Horghagen S, Nielsen D, Kristensen HK. Approaches to engaging people with dementia in meaningful occupations in institutional settings: A scoping review. Scand J Occup Ther. 2021;28(5):329-47. doi:10.1080/11038128.2020.1791952. [PubMed:32776817].
  11. Ciro CA, Hershey LA, Garrison D. Enhanced task-oriented training in a person with dementia with Lewy bodies. Am J Occup Ther. 2013;67(5):556-63. doi:10.5014/ajot.2013.008227. [PubMed:23968794].
  12. Hubbard IJ, Parsons MW, Neilson C, Carey LM. Task-specific training: evidence for and translation to clinical practice. Occup Ther Int. 2009;16(3-4):175-89. doi:10.1002/oti.275. [PubMed:19504501].
  13. Ciro CA, Poole JL, Skipper B, Hershey LA. Comparing Differences in ADL Outcomes for the STOMP Intervention for Dementia in the Natural Home Environment Versus a Clinic Environment. Austin Alzheimers Parkinsons Dis. 2014;1(1). [PubMed:28261703].
  14. Son BY, Bang YS, Hwang MJ, Oh EJ. Effect of task-oriented activities on hand functions, cognitive functions and self-expression of elderly patients with dementia. J Phys Ther Sci. 2017;29(8):1357-62. doi:10.1589/jpts.29.1357. [PubMed:28878462].
  15. Gbiri CAO, Amusa BF. Progressive task-oriented circuit training for cognition, physical functioning and societal participation in individuals with dementia. Physiother Res Int. 2020;25(4):e1866. doi:10.1002/pri.1866. [PubMed:32776698].
  16. Arevalo-Rodriguez I, Smailagic N, Roqué I Figuls M, Ciapponi A, Sanchez-Perez E, Giannakou A, et al. Mini-Mental State Examination (MMSE) for the detection of Alzheimer's disease and other dementias in people with mild cognitive impairment (MCI). The Cochrane database of systematic reviews. 2015;2015(3):CD010783-CD. doi:10.1002/14651858.CD010783.pub2. [PubMed:25740785].
  17. Dehghanizadeh M, Akbarfahimi M, Zareiyan A, Khalafbeigi M, Soleimani F. Research Paper: Predictors of Interest in Performing Activities Among Iranian Adolescents with Cerebral Palsy. Iranian Rehabilitation Journal. 2020;18(4):377-85.
  18. Hormozi S, Alizadeh-Khoei M, Sharifi F, Taati F, Aminalroaya R, Fadaee S, et al. Iranian Version of Barthel Index: Validity and Reliability in Outpatients' Elderly. International Journal of Preventive Medicine. 2019;10:130. doi:10.4103/ijpvm.IJPVM_579_18.
  19. Bruno D, Schurmann Vignaga S. Addenbrooke's cognitive examination III in the diagnosis of dementia: a critical review. Neuropsychiatr Dis Treat. 2019;15:441-7. doi:10.2147/NDT.S151253. [PubMed:30858702].
  20. Christopher A, Kraft E, Olenick H, Kiesling R, Doty A. The reliability and validity of the Timed Up and Go as a clinical tool in individuals with and without disabilities across a lifespan: a systematic review. Disabil Rehabil. 2019:1-15. doi:10.1080/09638288.2019.1682066. [PubMed:31656104].
  21. Chan WLS, Pin TW. Reliability, validity and minimal detectable change of 2-minute walk test, 6-minute walk test and 10-meter walk test in frail older adults with dementia. Exp Gerontol. 2019;115:9-18. doi:10.1016/j.exger.2018.11.001. [PubMed:30423359].
  22. Salavati M, Negahban H, Mazaheri M, Soleimanifar M, Hadadi M, Sefiddashti L, et al. The Persian version of the Berg Balance Scale: inter and intra-rater reliability and construct validity in elderly adults. Disabil Rehabil. 2012;34(20):1695-8. doi:10.3109/09638288.2012.660604. [PubMed:22380626].
  23. Aberson CL. Applied power analysis for the behavioral sciences. Routledge; 2019.
  24. Booth V, Harwood RH, Hood-Moore V, Bramley T, Hancox JE, Robertson K, et al. Promoting activity, independence and stability in early dementia and mild cognitive impairment (PrAISED): development of an intervention for people with mild cognitive impairment and dementia. Clin Rehabil. 2018;32(7):855-64. doi:10.1177/0269215518758149. [PubMed:29436253].
  25. Willey JZ, Moon YP, Kulick ER, Cheung YK, Wright CB, Sacco RL, et al. Physical Inactivity Predicts Slow Gait Speed in an Elderly Multi-Ethnic Cohort Study: The Northern Manhattan Study. Neuroepidemiology. 2017;49(1-2):24-30. doi:10.1159/000479695. [PubMed:28810247].
  26. Zhang W, Low LF, Schwenk M, Mills N, Gwynn JD, Clemson L. Review of Gait, Cognition, and Fall Risks with Implications for Fall Prevention in Older Adults with Dementia. Dement Geriatr Cogn Disord. 2019;48(1-2):17-29. doi:10.1159/000504340. [PubMed:31743907].
  27. Farajzadeh A, Akbarfahimi M, Maroufizadeh S, Miri Lavasani N. Factors Associated with Quality of Life among Caregivers of People with Spinal Cord Injury. Occup Ther Int. 2021:9921710. doi:10.1155/2021/9921710. [PubMed:34729057].