Occupational Therapy Part IV Occupational Therapy for Dementia and Depression

Research area: Rehabilitation and occupational therapy

Duration: March 2012 - June 2012
Publication: Project Report Nr. 60: https://eprints.aihta.at/974

Suggested by: Main Association of Austrian Social Security Institutions, Vienna
Language: German

Background:

Occupational Therapy for Dementia:
Dementia has far reaching consequences for patients and their caregivers, who are often relatives. Dementia impairs memory, causes behavioural problems and leads to loss of initiative and independence. The ability to master the demands of daily living is negatively affected, as is participation in social activities. Dementia is a chronic degenerative disease. Dementia progresses in stages and is generally not curable.
Dementia mostly affects elderly persons, though currently there is heightened interest in cases of dementia setting on before the age of 65. It is estimated that currently 36 million people suffer from dementia worldwide. This number is expected to double in the next two decades. The number of dementia patients in Austria is estimated at 100,000. In the year 2050 this number is expected to have risen to between 235,000 and 290,000 patients.
Occupational therapy aims to enable patients with dementia to master activities of daily living (personal hygiene, eating, dressing, rest and sleep), instrumental activities of daily living (cooking, housework, driving, banking), leisure and social participation.

Occupational Therapy for Depression:
Depression is among the most common mental illnesses. Depression often entails somatic comorbidity, a rise in the risk of suicide and at times severe mental suffering. It is estimated that by the year 2020 depression will have become the second leading cause of global burden of disease after cardio-vascular diseases. Data on the prevalence of mental illness in Austria is poor. In Western Europe the one-year-prevalence of major depression is approximately 5%.
Occupational therapy aims to enable patients with depression to master activities of daily living (personal hygiene, eating, dressing, rest and sleep), instrumental activities of daily living (cooking, housework, driving, banking), education, work, play, leisure and social participation.

Aim of project:

Occupational Therapy for Dementia:
The project aims to analyse evidence for the effectiveness of occupational therapy for patients suffering from dementia. A special focus will be on extramural interventions. The following details of occupational therapy interventions will be described: content, intensity, setting.

Occupational Therapy for Depression
The project aims to analyse evidence for the effectiveness of occupational therapy for patients suffering from depression. A special focus will be on extramural interventions. The following details of occupational therapy interventions will be described: content, intensity, setting. In the presentation of results the age of studied patients (below or above 60 years) and the severity of depression studied will be differentiated, as far as the literature allows.

Research question:

Occupational Therapy for Dementia:
Is occupational therapy for demented patients and/ or their caregivers compared to no intervention or compared to routine care more effective in terms of mastering activities of daily living including rest and sleep, leisure and social participation (patient), health and wellbeing (patient and caregiver), quality of life (patient and caregiver) and satisfaction (patient and caregiver)?

Occupational Therapy for Depression
Is occupational therapy for patients with depression compared to no intervention or as an additional intervention compared to treatment as usual more effective in terms of mastering activities of daily living, workforce participation, social participation, morbidity as in duration and severity of depression and quality of life?

Methods:

Occupational Therapy for Dementia
During initial research of the issue it turned out that the „American Occupational Therapy Association“ recently published the results of a wide ranging project with very similar research questions. This is why no renewed systematic search of the literature is undertaken by us. Instead, their results will be presented with a focus on evidence from controlled trials. In addition the results from an outpatient program of occupational therapy in the Netherlands and its implementation in a German context will be presented.

Occupational Therapy for Depression
Systematic search of the literature in various relevant data banks (Cochrane, CRD, Embase, Medline, OT-Seeker) supplemented with an unsystematic hand search.

Time schedule/ milestones:
March/ April 2012: initial researching of the field through a comprehensive unsystematic hand search, definition of the project protocol, systematic search of the literature, inclusion of studies, data extraction
May 2012: data extraction, composition of report
June 2012: composition of report, internal and external review, publication