Interventions to Improve or Maintain Activity of Daily Living Performance in Adults with Dementia: A Systematized Review

Importance: Dementia is a progressive cognitive disorder that leads to the degradation of one’s abilities until they are dependent for all activities of daily living (ADLs) (Andersen et al., 2004). There’s an increasing importance to search for effective ways to preserve independence in ADLs and quality of life for adults with dementia (Weng et al., 2019). Objective: To identify effective occupational therapy (OT) interventions for maintaining or improving ADL performance among adults with dementia. Data Sources: PubMed, CINAHL, PsycINFO. This search was conducted by a medical librarian. Design: Inclusion criteria encompassed interventions within the scope of OT, at least one outcome measure addressing ADL performance, and participants with dementia. Meta-analyses and systematic reviews were excluded. Findings: 24 studies met inclusion criteria: Thirteen IB, ten IIB and one IIIB studies. Five themes emerged including cognitive stimulation/training, physical exercise, task-oriented, multi-prong methods, and other interventions. Five IB, and one IIB studies provide strong strength of evidence for physical exercise. Three IIB studies provide low strength of evidence for other interventions. Three IB, and three IIB studies provide moderate strength of evidence for cognitive stimulation/cognitive training. One IB and one IIB study provide moderate strength of evidence for task-oriented. Four IB, two IIB, and one IIIB studies provide moderate strength of evidence for multi-prong interventions. Conclusion: Physical activity and task-based interventions should be used routinely to improve or maintain ADL performance in adults with dementia. Cognitive stimulation/training, multi-prong, and other interventions should be used on a case-by-case basis. References: Andersen, C.K., Wittrup-Jensen, K.U., Lolk, A., Andersen, K., & Kragh-Sørensen, P. (2004). Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health and Quality Life Outcomes, 2(52), 1-7. https://doi.org/10.1186/1477-7525-2-52 Weng, C.F., Lin, K.P., Lu, F.P., Chen, J.H., Wen, C.J., Peng, J.H., Tseng, A.H., & Chan, D.C. (2019). Effects of depression, dementia and delirium on activities of daily living in elderly patients after discharge. BMC Geriatrics, 19(1), 261. https://doi.org/10.1186/s12877-019-1294-9