France put a massive effort for improving dementia care through a
national Alzheimer plan in 2008 and this effort was confirmed by the
next government (Neurodegenerative Diseases Plan 2014-2019). Some new
care models and interventions have been implemented such as integrated
care, case management or occupational therapy.
A French observational study in real life showed that dementia
patients benefiting from occupational therapy sessions report relevant
clinical benefits over the intervention period, according to a research
study published in the Journal of Alzheimer's Disease
‘Occupational therapy for dementia patients reduces behavioral troubles, caregivers' burden and amount of informal care.’
The research suggested the influence of occupational therapy on
reducing behavioral troubles, caregivers' burden and amount of informal
care over the intervention period and a stabilization over the three-months
Occupational therapy has
been spread nationwide through specialized Alzheimer team intervening at
home with medical prescription. Even if efficacy of occupational
therapy has been demonstrated in some clinical trials, its efficacy
under routine care conditions was unknown and deserved to be
The research was conducted on a network of 16 specialized Alzheimer
team in Aquitaine, South West of France and was supported by the
regional agency of Health (Agence Régionale de la Santé d'Aquitaine).
Titled "Benefits of Occupational Therapy in Dementia Patients: Findings
from a Real-World Observational Study," the study included 421 dementia
patient who had been referred to occupational therapy by their general
practitioner or memory clinics and who had been followed up to six months.
Research studied the clinical evolution of patients between inclusion
and three month follow-up (end of the 15 home sessions) and between three and six-month follow-up (no session planned over this timeframe).
The study's results indicate that behavioral troubles, caregivers'
burden, amount of informal care provided by caregivers and patients'
quality of life were significantly reduced over the three-month intervention
period and remained stable thereafter. Cognitive performances remained
stable over the six-month study period and functional performances
remained stable over the three-month intervention period but were
significantly reduced thereafter.
Moreover, patients who had been
diagnosed more recently and those with milder cognitive deficits may
gain more benefits from occupational therapy in terms of functional
decline or caregivers' burden decline. These findings suggest that
occupational therapy should target early dementia stages in order to
optimize its potential clinical benefits.
In many Western countries, recent national guidelines have aimed at
improving home dementia care. This study highlights the potential
occupational therapy in terms of patients' and their caregivers'
well-being. The findings also opens a new field of research on
occupational therapy. Indeed, occupational therapy has been
conceptualized as a short-term home intervention, but long-term benefits
and consequences of disruption are unknown.
"Future studies should
explore more in detail which sub-groups of patients could gain more
benefits from OT as well as its long-term clinical effects notably on
global care quality and users' satisfaction" stated Clément Pimouguet.
Moreover, strategies aiming to improve initial benefits of
occupational therapy should be promoted. The French research team will
conduct a randomized trial that aim to compare the maintenance of
occupational therapy over an additional four-month period and usual
occupation therapy as recommended.