Abstract
Aging and chronic disease are on the rise in the United States. This paper presents the findings of a clinical trial that examined the preliminary efficacy of an OT intervention designed for adults age 55 and older with chronic health conditions.
Primary Author and Speaker: Mansha Mirza
Additional Authors and Speakers: Heidi Christine Fischer, Dalmina Arias
95% of older adults in the US have at least one chronic disease; 80% have two or more. Poor management of chronic diseases can offset a sequence of declining health and secondary complications such as mobility and ADL/IADL limitations especially in the aging population. Greater ADL/IADL limitation is also associated with lower self-efficacy in disease management. Thus, identifying and addressing ADL/IADL limitations early represents a novel approach to breaking the cycle of chronic disease and functional decline. This 2-arm parallel RCT examined the preliminary efficacy of an OT intervention designed for adults, aged 55 and over, with chronic health conditions. The 12-week preventive intervention included a comprehensive assessment of ADL functioning and ten intervention sessions addressing health management, physical deconditioning, and A/IADL limitations. 40 community-dwelling adults (avg age=67 yrs) with diabetes or heart disease were recruited through local clinics and community organizations. Main outcomes included: physical functioning (Patient Specific Functional Scale, Physical Performance Test, PROMIS Physical Functioning), self-efficacy for chronic disease management, health-related quality of life (PROMIS Global Health Measure), and ADL/IADL performance (Late Life Functioning and Disability Index). Data were analyzed using ANCOVA with baseline score as covariate and Sidak correction for multiple comparisons. A significant and large group effect in favor of the intervention group was found for the main outcome, Patient Specific Functional Scale (p = .04, d = 0.82, 95% CI [-1.5, -0.17]). Most other outcomes showed promising trends but effect sizes were small. The intervention showed preliminary efficacy in improving some outcomes for participants. Findings add to the OT evidence base for chronic disease management and can inform intervention strategies for clients aging with chronic disease. Future larger trials are needed to establish effectiveness.
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