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Occupational therapy in the elderly with dementia
Marjan Ghandi *, Reza Dehnavieh, Reza Goudarzi, Mostafa Almasi Doughaee, Malahat Akbarfahimi
Kerman University of Medical Sciences
Abstract:   (160 Views)
Objectives: As the population ages, the number of older people diagnosed with dementia is steadily increasing. Dementia is a chronic and progressive disease that causes memory disorders, behavioral problems, loss of initiative and independence in daily activities as well as the ability to participate in social activities. Occupational therapy is one of the most common psychological, social, cognitive, and motor behaviors implemented by the practitioner and increases patient confidence in self-esteem, self-improvement, and work-related behaviors.
Method: This research was conducted by health technology evaluation method. Evaluation of occupational therapy safety in the elderly was investigated by systematic review of studies, but no relevant data were found Effectiveness was then assessed through a randomized controlled trial of blind triple blindness at IRCT20191027045253N1, in which elderly patients with dementia whose disease was confirmed by a neurologist received 12 one-hour sessions of occupational therapy at home and with patients taking only medication. They were compared. For economic evaluation, based on the results of clinical trial, desirability and cost-effectiveness methods were used. For this purpose, from the perspective of the health system, the consequences and costs were extracted. The ethical, social and legal dimensions were assessed through interviews with neurologists, neuroscientists, geriatricians and occupational therapists, as well as patients and caregivers who participated in the trial.
Results: The results of a clinical trial to investigate changes in cognitive impairment through occupational therapy intervention in patients with dementia in mild to moderate disease showed that occupational therapy interventions have had a positive effect on cognition, quality of life and Barthelchr('39')s performance appraisal test. Informal patient care providers also received 12 occupational therapy sessions to accommodate and secure the home and reduce the burden of care. The results of statistical tests showed that depression, occupational equilibrium and time management were significant and had an effect on intervention for caregivers. Costs were extracted based on clinical trial results and calculated from the perspective of the health system which according to differences in outcomes and costs, occupational therapy technology was considered an effective cost.
Conclusion: The results of clinical trials and expert meetings show that occupational therapy technology is more likely to be safe in the elderly with dementia, with more effective sessions and economically cost-effective. The intervention was approved from the perspective of ethical, social and legal aspects, according to the opinion of experts and patients obtained through interviews.
Keywords: Dementia, Occupational Therapy, Elderly, Cost Effectiveness, Health Technology Assessment
     
Type of Study: Research | Subject: General
Received: 2021/06/20 | Accepted: 2021/07/24 | Published: 2021/08/1
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Ethics code: IR.KMU.REC.1398.329
Clinical trials code: IRCT20191027045253N1


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ghandi M, Dehnavieh R, Goudarzi R, Almasi Doughaee M, Akbarfahimi M. Occupational therapy in the elderly with dementia. 3. 2021; 1
URL: http://elderhealth.jmu.ac.ir/article-1-125-en.html


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همایش ملی سلامت سالمندی National Conference on Elderly Health
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