Tuesday, March 31, 2009

Occupational Therapy: The New Fountain of Youth?

     Occupational therapy has been gaining popularity in recent years for many of the benefits that it can provide for older adults. Many occupational therapists have been helping older adults to live safer and more independent lives. One recent study shows that occupational therapy may in fact help the elderly live longer.


     A recent randomized trial published in the Journal of the American Geriatrics Society looked at the mortality rates for a group of individuals enrolled in an intervention program called ABLE which combined preventive occupational therapy and physical therapy for older adult subjects.  Through this intervention program the subjects learned strategies such as home modifications, safety techniques, fall recovery techniques and balance and strength exercises. In a preceding study ABLE was shown to reduced many functional difficulties for older adults such as the fear of falling and introduced the use of assistive technology and home safety modifications. A randomized trial was conducted on subjects up to 4 years from the entry into the study. The results showed that at 2 years the participants who took part in the ABLE program had a mortality rate of 5.6% compared to a rate of 13.2% for the controls.  The results also showed that participants with a moderate mortality risk had a 16.7% mortality rate compared to 28.2% for controls with a moderate mortality risk.  Overall, the results from this randomized trial showed that the intervention group had up to a 3.5 year longer survival rate compared to the control group.

While the study could not state what exactly caused this increase in survivorship, one reason could be the education provided to the older adults through such programs as home safety and fall prevention.  According to the Center for Disease Control and Prevention, in 2005 15,800 people over the age of 65 died as a result of unintentional falls (CDC). Therefore, if occupational therapy fall prevention programs can help older adults learn about ways to change their environment for optimal safety then many of these deaths could be prevented. So while it cannot be proved that occupational therapy is the new fountain of youth, many studies are showing the benefits that it can have for older adults. Perhaps more fall preventive programs could be provided for at risk older adults. By enrolling in such programs, older adults may be able to live happy, healthier, and even longer lives.

American Occupational Therapy Association. Occupational therapy, physical therapy intervention extends lifespan and quality of life. http://www.healthnewsdigest.com/news/Research_270/Occupational_Therapy_Physical_Therapy_Intervention_Extends_Lifespan_and_Quality_of_Life.shtml

Gitlin, L. N., Hauck, W. W., Dennis, P. M., Winter, L., Hodgson, N. & Schnifeld, S. Long-term effect on mortality of a home intervention that reduces functional difficulties in older adults: Results from a a randomized trial. Journal of the American Geriatrics Society, 57, 417-481.

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Preventive Occupational Therapy May Provide Both Physical and Financial Benefits for the Elderly

            As the number of baby boomers reaching old age is increasing a lot of focus is being placed on aging successfully. While every person’s aging cycle is unique, studies have shown that engaging in meaningful activities helps to keep older adults healthy longer. Whether it is gardening or doing crafts, engaging in activities that have importance to the individual can significantly benefit their overall health as well as process of aging. Occupational therapy is now being used on healthy older adults in hopes of prolonging this healthy aging and preventing future health problems.

A study published in the Journal of the American Geriatrics Society observed a group of individuals who were enrolled in preventive occupational therapy and compared them with those who were not enrolled in such a group. (http://www3.interscience.wiley.com/cgi-bin/fulltext/118936796/PDFSTART)

The results showed that individuals enrolled in the preventive occupational therapy spent less on their healthcare costs after having completed the nine-month occupational therapy program. Individuals in this program spent about $967 on post intervention healthcare compared to $1726 for the active control group, $3334 for the passive control group, and $2593 for a combination of the control groups. 

This decrease in overall healthcare spending could be a result of increased education about successful aging. Occupational therapists help individuals to engage in activities that are meaningful to them. Perhaps this education to find a hobby proved to be a good coping mechanism for these individuals, in turn, increasing their overall health. More research needs to be done to determine what exactly is beneficial about the occupational therapy program. Perhaps just having someone to talk with on a weekly basis can help overall health outcomes. Whatever the reason, research shows that preventive occupational therapy is both cost effective as well as beneficial to health for older adults. 

Hay, J., LaBree, L., Lu,o R., Clark, F., Carlson, M., Mandel, D., et al. (2002), Cost-effectiveness preventive occupational therapy for independent-living older adults. Journal of the American Geriatrics Society, 50, 1381-1388.

Image from http://ot4life.com/resources/geriatrics.jpg.