Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

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Profile of Older Adults in Memory Outpatients' Clinic Setting and effectiveness of Novel Occupational Therapy Intervention in Patients with Mild to Moderate Dementia


Affiliations
1 KGMU Lucknow, SRF (ICMR), Occupational Therapist, AIIMS, New Delhi, India
2 Department of Geriatric Mental Health, KGMU, Lucknow, India
3 Department of Biostatistics, AIIMS, New Delhi, India
4 Department of Psychiatry, AIIMS, New Delhi, India
5 Department of Geriatric Mental Health, KGMU, Lucknow, 6Professor and Head, Department of Geriatric Medicine, AIIMS, New Delhi, India
6 Department of Geriatric Medicine, AIIMS, New Delhi, India
     

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Background: Researchers and clinicians are working hard for prevention and management of dementia and its complications, no definite remedy is available now. Our aim is to investigate effects of occupational therapy in maintaining quality of life of patients having mild to moderate dementia.

Methodology: 263 older subjects (new-182, old-81) were included between November 2010 and April 2013. After screening of all patients by a geriatrician, 192 were excluded having [Cognitive impairment with no dementia (CIND)]. Rest 71 patients were included after satisfying DSM IV criteria and were randomly assigned to experimental and control groups. Experimental group received newly developed occupational therapy intervention along with the drug, and control group received only drug for a period of 5 weeks. Both groups were evaluated using the six outcome measures a) Folstein Mini Mental status examination, b) Geriatric Depression scale Hindi Version c)Bristol Activity of daily Living, d) Modified Physical Performance test, e) BEHAV-AD, f)WHO QOL [Hindi Version] obtained baseline and reassessment after 5 weeks.

Result: Included subjects with mean age 69.39 having 33.80% of primary education, 32.39 % up to class 12, 47.88% of living with spouse, 47.88% of living with spouse and family, 78.87% married, 16.9% widowed, 22.53% unemployed, 43.66% retired. After application of novel occupational therapy on experimental group there is statistically improvement in the domain of Depression, ADL, Physical performance, and quality of life, out of all six domains.

Conclusion: The study reveals that the newly developed occupational therapy program can improve behavioral status, functionality, physical performance, mood and quality of life in elderly dementia patient at short term. A follow up study is required to ascertain the long term effect of treatment.


Keywords

Novel Occupational Therapy Intervention Programme and Dementia
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  • Alzheimer’s Association. Alzheimer’s disease facts and figures. Chicago (IL): Alzheimer’s Association; 2010.

  • Meerding. The costs of intervention belong to top 3 of health care costs. BMJ 1998; (11) 317: 111-115.

  • Alzheimer Society of Canada. Rising tide: the impact of dementia on Canadian society. Toronto, Canada; 2010.

  • American Psychiatric Association. (2000). American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000. (4th ed.). Washington, D.C.: American Psychiatric Association.

  • Cahill S, Begley E, Faulkner JP, Hagen I. ‘‘It gives me a sense of independence’’ – findings from Ireland on the use and usefulness of assistive technology for people with dementia. Technol Disabil 2007;19:133–42.

  • Wherton JP, Monk AF. Technological opportunities for supporting people with dementia who are living at home. Int J Human- Comp Studies 2008;66:571–86.

  • Stone R, Cafferata GL, Sangl J. Caregivers of the frail elderly: a national profile. Gerontologist 1987;27:616–26.

  • Yang JJ, Mann WC, Nochajski S, Tomita MR. Use of assistive devices among elders with cognitive impairment: a follow-up study. Top Geriatr Rehabil 1997;13:13–31.

  • American Geriatric Society. (2009). A guide to dementia diagnosis and treatment. Retrieved June 16, 2010, from American Geriatrics Society Website: http://dementia.americangeriatrics.org

  • Ferri CP, Prince M, Brayne C, Broadty H, fratiglioni L, Ganguli M, et al. Globa prevalence of Dementia: A Delphi consensus study. Lancet 2005; 366: 2112-7.

  • Whiteford, G. and Fossey, E. (2002). Occupation: The essential nexus between philosophy, theory and practice. Australian Occupational Therapy Journal, 49(1), 1-2

  • Graff MJ, Vernooij-Dassen MJ, Hoefnagels WH, Dekker J, de Witte LP. Occupational therapy at home for older individuals with mild to moderate cognitive impairments and their primary caregivers: a pilot study. Occup Ther J Res. 2003;23: 155–163.

  • Gail Whiteford, Ellie Fossey;Occupation: The essential nexus between philosophy, theory and practice. Australian Occupational Therapy Journal 2002; 49: 1-56.

  • Patiricia A. Miller, Danielle Butin; The role of occupational therapy in dementia-C.O.P.E( caregiver options for practical experiences); International journal of geriatric psychiatric; 15, 86-89 (2000).

  • Hasselkus BR. Etnografic interviewing: A tool for practice with family caregivers for the elderly. Occup Ther Pract 1990; 2: 9-16.

  • kielhofner, G . Model of Human occupation: Theory and application (3rd ed.)Baltimore: Lippincott Williams and Wilkins, 2002.

  • Law, M. Baptiste, S. Carswell, A. Palatajko, H. & Pollock , N. Canadian Occupational Performance Measure (3rd ed). Toronto, Ontario, Canada : CAOT Publication ACE, 1998

  • Cole M, applied theories in occupational therapy: a practical approach instructor ’s manual. Thorofare, NJ: SLACK Incorporated

  • Reed K. Models of practice in occupational therapy. Baltimore, 1981, Williams and Wilkins.

  • Prakash kumar, SC Tiwari, Rakesh Tripathi, PC Das, P Chatterjee, A B Dey; Occupational therapy for cognitive impairment in a memory clinic; Journal of The India Academy of Geriatrics vol. 7, No. 3, September, 2011, Pg No-121.

  • Graff MJ, Melick van MBM. The development, testing and implementation of an occupational therapy guideline. The guideline for the OT diagnosis and treatment of older persons with cognitive impairments. Ned Tijdschr Ergother. 2000;28: 169–174. [In Dutch]

  • Prakash Kumar, PC Das, P Chatterjee, AB Dey: A Novel Occupational Therapy Strategy for Cognitive Impairment in Old Age, Journal of The Indian Academy of Geriatrics, 2012; 8: 120-123)

  • Jacobson, E. (1938). Progressive relaxation. Chicago: University of Chicago Press

  • Rogers RL, Meyer JS, Mortel KF. After reaching retirement age physical activity sustains cerebral perfusion and cognition. J Am Geriatr Soc. 1990;38:123-128.

  • Emery CF, Gatz M. Psychological and cognitive effects of an exercise program for communityresiding older adults. Gerontologist. 1990;30:184- 188.

  • KEEP YOUR BRAIN ALIVE by Lawrence C. Kartz, PhD & Manning Rubin, Workman Publishing company. http:// keepyourbrainalive.com/explain.html

  • Folstein MF, Folstein SE, McHugh PR: “Minimental state: A practical method for grading the cognitive state of patients for the clinician.” J Psychiatr Res 1975; 12:189-198.

  • http://www.stanford.edu/~yesavage/ Hindi.html

  • web.missouri.edu/~proste/.../Physical- Performance-Test-modified.rtf

  • http://ageing.oxfordjournals.org/content/25/ 2/113.full.pdf

  • Barry Reisberg, Stefanie R. Auer and Isabel M. Monteiro (1997). Behavioral Pathology in Alzheimer’s Disease (BEHAVE-AD) Rating Scale. International Psychogeriatrics, 8 , pp 301-308 doi:10.1017/S1041610297003529

  • http://www.who.int/substance_abuse/ research_tools/en/english_whoqol.pdf

  • Gitlin LN, Corcoran M, Winter L, Boyce A, Hauck WW. A randomised, controlled trial of a home environment intervention: effect on efficacy and upset in caregivers and on daily functioning of person with dementia. Gerontologist 2001; 41:4- 14

  • Maud J L Graff, Myrra J M Vernooij-Dassen, Marjolein Thijssen, Joost Dekker, Willibrord H L Hoefnagels, Marcel GM Olde Rikkert ;Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial BMJ, doi:10.1136/ bmj.39001.688843.BE (published 17 November 2006)


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  • Profile of Older Adults in Memory Outpatients' Clinic Setting and effectiveness of Novel Occupational Therapy Intervention in Patients with Mild to Moderate Dementia

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Authors

Prakash Kumar
KGMU Lucknow, SRF (ICMR), Occupational Therapist, AIIMS, New Delhi, India
S. C. Tiwari
Department of Geriatric Mental Health, KGMU, Lucknow, India
V. Sreenivas
Department of Biostatistics, AIIMS, New Delhi, India
Nand Kumar
Department of Psychiatry, AIIMS, New Delhi, India
R. K. Tripathi
Department of Geriatric Mental Health, KGMU, Lucknow, 6Professor and Head, Department of Geriatric Medicine, AIIMS, New Delhi, India
A. B. Dey
Department of Geriatric Medicine, AIIMS, New Delhi, India

Abstract


Background: Researchers and clinicians are working hard for prevention and management of dementia and its complications, no definite remedy is available now. Our aim is to investigate effects of occupational therapy in maintaining quality of life of patients having mild to moderate dementia.

Methodology: 263 older subjects (new-182, old-81) were included between November 2010 and April 2013. After screening of all patients by a geriatrician, 192 were excluded having [Cognitive impairment with no dementia (CIND)]. Rest 71 patients were included after satisfying DSM IV criteria and were randomly assigned to experimental and control groups. Experimental group received newly developed occupational therapy intervention along with the drug, and control group received only drug for a period of 5 weeks. Both groups were evaluated using the six outcome measures a) Folstein Mini Mental status examination, b) Geriatric Depression scale Hindi Version c)Bristol Activity of daily Living, d) Modified Physical Performance test, e) BEHAV-AD, f)WHO QOL [Hindi Version] obtained baseline and reassessment after 5 weeks.

Result: Included subjects with mean age 69.39 having 33.80% of primary education, 32.39 % up to class 12, 47.88% of living with spouse, 47.88% of living with spouse and family, 78.87% married, 16.9% widowed, 22.53% unemployed, 43.66% retired. After application of novel occupational therapy on experimental group there is statistically improvement in the domain of Depression, ADL, Physical performance, and quality of life, out of all six domains.

Conclusion: The study reveals that the newly developed occupational therapy program can improve behavioral status, functionality, physical performance, mood and quality of life in elderly dementia patient at short term. A follow up study is required to ascertain the long term effect of treatment.


Keywords


Novel Occupational Therapy Intervention Programme and Dementia

References