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Occupational Therapy for Independent-Living Older AdultsA Randomized Controlled Trial
Florence Clark, PhD, OTR;
Stanley P. Azen, PhD;
Ruth Zemke, PhD, OTR;
Jeanne Jackson, PhD, OTR;
Mike Carlson, PhD;
Deborah Mandel, MS, OTR;
Joel Hay, PhD;
Karen Josephson, MD;
Barbara Cherry, PhD;
Colin Hessel, MS;
Joycelynne Palmer;
Loren Lipson, MD
JAMA. 1997;278(16):1321-1326.
Abstract
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Context.
—Preventive health programs may mitigate against the health risks of older adulthood.
Objective.
—To evaluate the effectiveness of preventive occupational therapy (OT) services specifically tailored for multiethnic, independent-living older adults.
Design.
—A randomized controlled trial.
Setting.
—Two government subsidized apartment complexes for independentliving older adults.
Subjects.
—A total of 361 culturally diverse volunteers aged 60 years or older.
Intervention.
—An OT group, a social activity control group, and a nontreatment control group. The period of treatment was 9 months.
Main Outcome Measures.
—A battery of self-administered questionnaires designed to measure physical and social function, self-rated health, life satisfaction, and depressive symptoms.
Results.
—Benefit attributable to OT treatment was found for the quality of interaction scale on the Functional Status Questionnaire (P=.03), Life Satisfaction Index-Z (P=.03), Medical Outcomes Study Health Perception Survey (P=.05), and for 7 of 8 scales on the RAND 36-Item Health Status Survey, Short Form: bodily pain (P=.03), physical functioning (P=.008), role limitations attributable to health problems (P=.02), vitality (P=.004), social functioning (P=.05), role limitations attributable to emotional problems (P=.05), and general mental health (P=.02).
Conclusions.
—Significant benefits for the OT preventive treatment group were found across various health, function, and quality-of-life domains. Because the control groups tended to decline over the study interval, our results suggest that preventive health programs based on OT may mitigate against the health risks of older adulthood.
Author Affiliations
From the Department of Occupational Science and Occupational Therapy, University of Southern California (Drs Clark, Zemke, Jackson, Carlson, and Cherry and Ms Mandel); Statistical Consultation and Research Center, Department of Preventive Medicine, University of Southern California School of Medicine (Dr Azen, Mr Hessel, and Ms Palmer); Department of Pharmaceutical Economics and Policy, University of Southern California School of Pharmacy (Dr Hay); and Division of Geriatric Medicine, Department of Medicine, University of Southern California School of Medicine (Drs Josephson and Lipson), Los Angeles.
Footnotes
Reprints: Florence Clark, PhD, OTR, Department of Occupational Science and Occupational Therapy, 1540 Alcazar, CHP 133, Los Angeles, CA 90033.
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