Date Presented4/8/2016
Age, leisure activity participation, and depressive symptoms are all significant predictors of instrumental activity of daily living function. Occupational therapists can incorporate evidence-based interventions to address both depressive symptoms and leisure activity participation.
Primary Author and Speaker: Szu-Wei Chen
Additional Author and Speaker: Tracy Chippendale
PURPOSE: To explore the association of age, depressive symptoms, and level of leisure activity participation with instrumental activity of daily living (IADL) independence and the relative importance of these three factors in predicting IADL independence
RATIONALE: With the rapid increase in the senior population, occupational therapists play an important role in assisting seniors to successfully age in place. Occupational therapists support seniors’ ability to engage in areas of occupation at home and in the community. IADLs, as a crucial area of occupation, are less addressed in occupational therapy (OT) practice compared with activities of daily living (ADLs). However, seniors spend most of their time participating in IADL-related activities, and IADLs are often used for evaluating functional capacity along with ADLs.
Furthermore, IADL status can serve as an early detector of future functional loss, because difficulty in executing IADLs usually precedes that of ADLs. Therefore, understanding possible factors that are associated with IADL independence could provide OT practitioners insight and inform practice regarding how to bring about changes in seniors’ IADL function.
In our study, we focused on the factors of age, depressive symptoms, and level of leisure activity participation, because these three factors, compared with other predetermined factors, are feasible for occupational therapists to consider in planning a series of health promotion programs.
DESIGN: This study is a cross-sectional design.
PARTICIPANTS: Ninety-eight older adults who resided in senior housing or their own home/apartment were included in the study. Inclusion criteria were age 60 yr and older, English speaking, and a negative screen for probable dementia on the Mini-Cog.
METHOD: An existing dataset that combined pretest data from two community-based intervention studies was used. In the original studies, the Geriatric Depression Scale 30-item version was used to assess depressive symptoms. Data on age and frequency of participation in leisure activities was collected through self-report.
ANALYSIS: Correlations were first examined between the independent and dependent variables as well as among the three independent variables. A simultaneous multiple regression analysis was then used to examine the importance of each of the predictor variables.
RESULTS: The model predicting level of independence in IADL using age, leisure activity participation, and depressive symptoms as predictor variables was significant, F(3, 96) = 15.6, p < .0001, and explained 31.3% of the variance in IADL independence. Although age was the strongest of the three predictors, accounting for 11.4% of the variance in IADL independence, participation in leisure activities and depressive symptoms were also significant predictors, accounting for 4.3% and 7.3% of the variance in IADL, respectively.
DISCUSSION: Although age, associated with decreased IADL independence, is not amenable to change, other significant predictors can be addressed through OT interventions, including adaptive approaches to enhance leisure activity participation (e.g., adapting the environment or leisure activity) and nonpharmacological interventions to decrease depressive symptoms (e.g., life review and/or cognitive behavioral approaches).
IMPACT STATEMENT: Independence in IADLs is important in promoting the ability of older adults to age in place. Understanding factors associated with IADL independence that are amenable to late-life change can help to inform OT practice.
