Date Presented 04/03/2025
This feasibility study assessed a cognitive-functional Zoom intervention to improve participation among community-dwelling older adults at risk of reduced participation because of crises such as COVID-19. Significant improvements support further research.
Primary Author and Speaker: Bilha Melamed
Additional Authors and Speakers: Rachel Kizony
Contributing Authors: Maayan Agmon
PURPOSE: Evidence-based, cognitive-functional interventions to improve participation in daily activities among community-dwelling older adults are lacking in occupational therapy. This study examined the feasibility of such an intervention among community-dwelling older adults who experienced reduced participation during the COVID-19 pandemic.
DESIGN AND METHOD: A mixed-methods, quantitative and qualitative, feasibility pre- and post-study was employed. The sample included 11 participants (7 women) aged 65 and older (Mean = 75.9, SD = 5.88), community-dwelling, Montreal Cognitive Assessment (MoCA) ≥ 18, retired at least two years, experiencing participation restriction, walking independently and without an acute neurological or orthopedic diagnosis. The primary outcome measure was the Canadian Occupational Performance Measure (COPM) which included performance and satisfaction from performance scales. Secondary outcome measures were the Cognitive Self-Efficacy Questionnaire (CSEQ), the Weekly Calendar Planning Activity (WCPA), a cognitive-functional assessment and participant experiences post-intervention via a semi-structured interview. The Intervention was based on the Multicontext Approach focusing on training cognitive strategies to enhance participation, was led by an occupational therapist over eight group sessions via Zoom.
RESULTS: Significant pre-post increase in COPM performance scale (Z = -2.207, p = .027, r = .67), improvement in CSEQ (Z = -2.936, p = .003, r = .89), and use of significantly more strategies, in the WCPA (Z = -2.214, p = .027, r = .74). Analysis of the interviews indicated that the group meetings were meaningful and helped the participants to return to previous activities as well as adapt participation to the current situation.
CONCLUSION: The findings lay the foundation for employing this intervention in future studies with this population, which is at risk for participation restrictions due to crises.
References
Heid AR, Cartwright F, Wilson-Genderson M, Pruchno R (2021) Challenges experienced by older people during the initial months of the COVID-19 pandemic. Gerontologist 61:48–58. https://doi.org/10.1093/geront/gnaa138
Toglia, J., & Foster, E. E. (2021). The Multicontext Approach to Cognitive Rehabilitation. Gatekeeper Place. https://www.target.com/p/the-multicontext-approach-to-cognitiverehabilitation-by-joan-toglia-erin-r-foster-paperback/-/A-83426367
Jethani PM, Toglia J, Foster ER. Cognitive Self-Efficacy in Parkinson’s Disease. OTJR: Occupational Therapy Journal of Research. 2023;0(0). https://doi.org/10.1177/15394492231206346
