An occupation-based strategy training approach to managing age-related executive changes: a pilot randomized controlled trial

作者：Dawson Deirdre^*; Richardson Julie; Troyer Angie; Binns Malcolm; Clark Amanda; Polatajko Helene; Winocur Gordon; Hunt Anne; Bar Yael

来源：Clinical Rehabilitation, 2014, 28(2): 118-127.

DOI：10.1177/0269215513492541

• Aging
• cognitive impairment
• controlled clinical trial
• rehabilitation interventions
• strategy-training

Objective: To determine the feasibility of recruitment and retention of healthy older adults and the effectiveness of an intervention designed to manage age-related executive changes. %26lt;br%26gt;Design: A pilot randomized controlled trial. %26lt;br%26gt;Setting: Research centre and participants%26apos; homes. %26lt;br%26gt;Participants: Nineteen healthy, community dwelling older adults with complaints of cognitive difficulties and everyday problems, but no evidence of mild cognitive impairment, dementia or depression on objective testing. %26lt;br%26gt;Interventions: Seventeen hours of group and individual training. Participants in the experimental arm received education about self-management, successful aging and an occupation-based meta-cognitive strategy-training program. Participants in the control arm received education about brain health and participated in cognitively stimulating exercises. %26lt;br%26gt;Main measures: Changes on untrained, everyday life goals were identified using the Canadian Occupational Performance Measure. Generalization of benefits was measured using the Stanford Chronic Disease Questionnaire, general self-efficacy and changes in executive Delis-Kaplan Executive Function System Tower Test, Word Fluency and Trail-Making Test). %26lt;br%26gt;Results: 20% (19/96) of healthy older adults approached were eligible, consented and were enrolled in the study, 90% (17/19) were retained to three-month follow-up. Participants in the experimental arm reported significantly more improvement on untrained goals (11/22 compared with 9/46, (2)=4.92, p%26lt;0.05), maintenance of physical activity (p%26lt;0.05) and better preparation for doctors%26apos; visits (p%26lt;0.05) relative to the control group. There were no significant between group differences on objective measures of executive function. %26lt;br%26gt;Conclusions: These data support the feasibility of a larger trial where a sample of 72 (36 participants in each arm) would be required to confirm or refute these findings.

• 出版日期2014-2